Provider Demographics
NPI:1184068330
Name:BAILOR, THOMAS GERARD
Entity type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:GERARD
Last Name:BAILOR
Suffix:
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 1:316 BAYWINDS COURT
Mailing Address - Street 2:
Mailing Address - City:DAGSBORO
Mailing Address - State:DE
Mailing Address - Zip Code:19939
Mailing Address - Country:US
Mailing Address - Phone:302-245-9986
Mailing Address - Fax:302-537-4141
Practice Address - Street 1:316 BAYWINDS COURT
Practice Address - Street 2:
Practice Address - City:DAGSBORO
Practice Address - State:DE
Practice Address - Zip Code:19939
Practice Address - Country:US
Practice Address - Phone:302-245-9986
Practice Address - Fax:302-537-4141
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-18
Last Update Date:2013-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DE13-93071-54171WH0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171WH0202XOther Service ProvidersContractorHome Modifications