Justin Bailey

Individual provider Active NPI Student in an Organized Health Care Education/Training Program · Taos, NM

NPI 1881479871 · NPPES record last updated Dec 22, 2023

Key facts

NPI
1881479871
Entity type
Individual (NPI type 1)
Primary specialty
Student in an Organized Health Care Education/Training Program 390200000X
Practice address
105 Bertha Rd Ste B
Taos, NM 87571-7148
Phone
(575) 758-4297
NPI assigned
Aug 28, 2023
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Yes

Addresses

Primary practice location

105 Bertha Rd Ste B
Taos, NM 87571-7148

Mailing address

7193 Highway 518
Ranchos de Taos, NM 87557-9758

Other providers in Taos, NM

All providers in Taos, NM · Student in an Organized Health Care Education/Training Program in New Mexico

Sources for this page

Verify at the official NPI Registry.