Bailey, Terald Otis

Bailey, Terald Otis is an individual health care provider with primary practice located at 1883 Highway 43 South Ste D, Canton MS 39046. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Family Medicine. Allopathic & Osteopathic Physicians / Internal Medicine is his primary health care specialty. Bailey, Terald Otis can be contacted via phone (601) 859-8992.

Contact Information

Primary practice address
1883 Highway 43 South Ste D Canton MS 39046
Phone: (601) 859-8992
Fax: (601) 855-5265
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 06976 Mississippi
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 06976 Mississippi

Profile Details

NPI number 1780694083
LBN Legal business name Bailey, Terald Otis
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 9th, 2006
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1780694083 NPPES
Mississippi MEDICAID 0123908

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