Provider Demographics
NPI:1366979304
Name:YOUNG, BAILEY WALKER (DO)
Entity type:Individual
Prefix:DR
First Name:BAILEY
Middle Name:WALKER
Last Name:YOUNG
Suffix:
Gender:F
Credentials:DO
Other - Prefix:DR
Other - First Name:BAILEY
Other - Middle Name:MARIE
Other - Last Name:WALKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:PO BOX 776879
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60677-6879
Mailing Address - Country:US
Mailing Address - Phone:502-588-9490
Mailing Address - Fax:502-272-5116
Practice Address - Street 1:2933 BRECKENRIDGE LN STE 103
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40220-1494
Practice Address - Country:US
Practice Address - Phone:502-394-5678
Practice Address - Fax:502-394-5600
Is Sole Proprietor?:No
Enumeration Date:2017-05-22
Last Update Date:2023-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY05619207X00000X
KYTP801207XP3100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No207XP3100XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryPediatric Orthopaedic Surgery