Brandy Bailey
Individual provider Active NPI Optician · Malta, OH
NPI 1073380929 · NPPES record last updated Dec 11, 2023
Key facts
- NPI
- 1073380929
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optician 156FX1800X
- License
- SC9958 (OH)
- Practice address
- 902 N Main St
Malta, OH 43758-9006 - Phone
- (740) 621-0657
- NPI assigned
- Dec 11, 2023
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SC9958 | OH | MD | Optician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optician | 156FX1800X | SC9958 | OH | Yes |
Addresses
Primary practice location
902 N Main St
Malta, OH 43758-9006
Mailing address
902 N Main St
Malta, OH 43758-9006
Phone (740) 621-0657
Other providers in Malta, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 11, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.