Keith Bailey

NPI 1033481577 · on the registry since 2012 · sole proprietor

Practice

Address: 16700 N Market Place Blvd
Nampa, ID 83687
Phone: (208) 465-3809
Organisation at this address: Costco Wholesale Corporation
Costco Wholesale Corporation
Costco Wholesale Corporation
Inferred from a shared address, not stated in the registry.
Clinicians at this address: 4

Registry record

Primary taxonomy: 183500000X
183500000X
Licence states on file: ID
From the registry's licence fields, which are often incomplete.
Sex: Male
Record last updated: 2012-01-30

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Idaho