Bailey, Gomer Ray
Bailey, Gomer Ray is an sole proprietor health care provider with primary practice located at 12201 Euclid Ave , Cleveland OH 44106-4310. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Bailey, Gomer Ray can be contacted via phone (216) 707-3478.Contact Information
Primary practice address
12201 Euclid Ave
Cleveland OH 44106-4310
Phone: (216) 707-3478
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X | 6583 | Ohio |
Profile Details
| NPI number | 1740529817 |
|---|---|
| LBN Legal business name | Bailey, Gomer Ray |
| Credentials | PHD |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Feb 8th, 2013 |
| Last updated | Feb 24th, 2021 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1740529817 | NPPES |
| Ohio | MEDICAID | 0218310 |
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