| Samuel A Bailey, PA | |
|
6800 State Route 162, Maryville, IL 62062-8500 | |
| (800) 968-6866 | |
| Not Available |
| Full Name | Samuel A Bailey |
|---|---|
| Gender | Male |
| Speciality | Physician Assistant |
| Location | 6800 State Route 162, Maryville, Illinois |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891778254 | NPI | - | NPPES |
| 085001646 | Other | IL | BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363A00000X | Physician Assistant | 85001646 (Illinois) | Primary |
| 207P00000X | Emergency Medicine | 085-001646 (Illinois) | Secondary |
| Entity Name | Southeastern Emergency Services of Memphis PC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1164454450 PECOS PAC ID: 8921912767 Enrollment ID: O20150428000000 |
| Entity Name | Southeastern Emergency Physicians of Memphis LLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1437105277 PECOS PAC ID: 5395643209 Enrollment ID: O20150520001245 |
| Mailing Address | Practice Location Address |
|---|---|
| Samuel A Bailey, PA Po Box 66971, Saint Louis, MO 63166-6971 Ph: (800) 968-6866 | Samuel A Bailey, PA 6800 State Route 162, Maryville, IL 62062-8500 Ph: (800) 968-6866 |
Mrs. Mallory Jean Henson, PA Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 6800 State Route 162 Ste 200, Maryville, IL 62062 Phone: 618-288-0900 Fax: 618-288-0909 |
Maria Catalano, PA Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 6800 State Route 162, Maryville, IL 62062 Phone: 161-828-8571 |
Michael Barajas, PA Physician Assistant Medicare: Medicare Enrolled Practice Location: 6812 State Route 162, Suite 120, Maryville, IL 62062 Phone: 618-288-0044 Fax: 618-288-0066 |
Mrs. Christine Werner, PA-C Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 2704 N Center St, Maryville, IL 62062 Phone: 618-288-0656 |
Jessica Leigh Gibson, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 2704 N Center St, Maryville, IL 62062 Phone: 270-556-8641 |
Jessica Nussbaum, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 6812 State Route 162 Ste 120, Maryville, IL 62062 Phone: 618-288-0044 |
Sarah E Wiegman, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 6800 State Route 162, Maryville, IL 62062 Phone: 618-288-5711 |