| Organization Name: | GARY BAILEY, DO, PC |
| NPI Number: | 1164611836 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | GARY W BAILEY (OWNER) |
| Mailing Address: | 2525 Burton St Se Grand Rapids |
| State: | MI US |
| Postal Code: | 495464834 |
| Phone Number: | 6169572410 |
| Fax Number: | 6169572411 |
| NPI Enumeration Date: | 10/18/2007 |
| NPI Last Update Date: | 10/18/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 5101007477 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MI |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |