Provider Demographics
NPI:1487490561
Name:DUCKETT, BAILEY SCOTT (DPT)
Entity type:Individual
Prefix:
First Name:BAILEY
Middle Name:SCOTT
Last Name:DUCKETT
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 S FLORIDA ST
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36606-1927
Mailing Address - Country:US
Mailing Address - Phone:251-501-2700
Mailing Address - Fax:251-501-2701
Practice Address - Street 1:108 S FLORIDA ST
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36606-1927
Practice Address - Country:US
Practice Address - Phone:251-501-2700
Practice Address - Fax:251-501-2701
Is Sole Proprietor?:No
Enumeration Date:2024-07-08
Last Update Date:2024-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPTH11988225100000X
TN157392251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic