Provider Demographics
NPI:1548492010
Name:BAILEY, ERIK LEWIS (DC)
Entity type:Individual
Prefix:DR
First Name:ERIK
Middle Name:LEWIS
Last Name:BAILEY
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:575 PUMPKIN LOOP
Mailing Address - Street 2:
Mailing Address - City:DERIDDER
Mailing Address - State:LA
Mailing Address - Zip Code:70634-7904
Mailing Address - Country:US
Mailing Address - Phone:337-396-9433
Mailing Address - Fax:
Practice Address - Street 1:1606 N PINE ST
Practice Address - Street 2:
Practice Address - City:DERIDDER
Practice Address - State:LA
Practice Address - Zip Code:70634-2420
Practice Address - Country:US
Practice Address - Phone:337-462-3055
Practice Address - Fax:337-462-0741
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-18
Last Update Date:2012-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1516111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor