Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YX0007X | Plastic Surgeon (Head & Neck) | 41765 | IL |
NPI | 1396912911 |
---|---|
Provider Name | Dr. Samuel Steven Bailey |
First Address | Scottsdale, AZ 85255-4134 |
Second Address | Scottsdale, AZ 85255-4134 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/05/2008 |
Last Update Date | 15/09/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1396912911 | BCBS (01) | AZ |
3Z0953 | HEALTH NET (01) | AZ |
458194 | (05) | AZ |