Provider Demographics
NPI:1447023056
Name:BAILEY, DEON SR
Entity type:Individual
Prefix:
First Name:DEON
Middle Name:
Last Name:BAILEY
Suffix:SR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1950 BYRON DR
Mailing Address - Street 2:
Mailing Address - City:BRUNSWICK
Mailing Address - State:OH
Mailing Address - Zip Code:44212-4002
Mailing Address - Country:US
Mailing Address - Phone:216-855-6343
Mailing Address - Fax:
Practice Address - Street 1:1950 BYRON DR
Practice Address - Street 2:
Practice Address - City:BRUNSWICK
Practice Address - State:OH
Practice Address - Zip Code:44212-4002
Practice Address - Country:US
Practice Address - Phone:216-855-6343
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-06
Last Update Date:2023-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes376J00000XNursing Service Related ProvidersHomemaker
No172A00000XOther Service ProvidersDriverGroup - Multi-Specialty
No253Z00000XAgenciesIn Home Supportive Care