Benjamin Barroga Bailon, M.D.
Individual provider Active NPI Family Medicine Physician · Thomasville, GA
NPI 1629023486 · NPPES record last updated Apr 5, 2018
Key facts
- NPI
- 1629023486
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 027025 (GA)
- Practice address
- 116 Rosedale Ave
Thomasville, GA 31792-6655 - Phone
- (229) 228-6577
- Fax
- (229) 228-4708
- NPI assigned
- May 23, 2006
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 027025 | GA | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Complete Care & Pain Management Institute,LLC | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 027025 | GA | Yes |
Addresses
Primary practice location
116 Rosedale Ave
Thomasville, GA 31792-6655
Mailing address
40 Highway 122 Connector
Lakeland, GA 31635-5713
Phone (229) 563-0098
Other practice location 1
342 Corder Rd Ste B
Warner Robins, GA 31088-3640
Phone (478) 302-5106
Other practice location 2
2025 Palmyra Rd
Albany, GA 31701-1576
Phone (229) 439-7100
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00294137A | Medicaid | GA |
Other providers in Thomasville, GA
- Charlotte Austin
- Daniel James Badger
- Sarah Baggett
- Grover L. Bailey
- Michael Scott Bailey
- Charles Baker
- Marjorie Pomeroy Baker
- Megan Baldwin
- Melanie Jai Balfour
- Prashant Baliga
All providers in Thomasville, GA · Family Medicine Physician in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 5, 2018. 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.