Basic Information
| Provider Information | |||||||||
| NPI: | 1396739140 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BAILEY | ||||||||
| FirstName: | ALLAN | ||||||||
| MiddleName: | HAROLD | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 104 WOODMONT BLVD | ||||||||
| Address2: | SUITE LL50 | ||||||||
| City: | NASHVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 372052245 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6153862361 | ||||||||
| FaxNumber: | 6153862399 | ||||||||
| Practice Location | |||||||||
| Address1: | 2010 CHURCH STREET | ||||||||
| Address2: | SUITE 420 | ||||||||
| City: | NASHVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 372032010 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6153292141 | ||||||||
| FaxNumber: | 6153210522 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/08/2005 | ||||||||
| LastUpdateDate: | 12/16/2015 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RG0100X | MD0000017191 | TN | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Gastroenterology |
ID Information
| ID | Type | State | Issuer | Description | 100007065 | 01 | TN | RAILROAD MEDICARE | OTHER | 3019996 | 05 | TN | MEDICAID | 3019995 | 05 | TN | MEDICAID |