Provider Demographics
NPI:1568212181
Name:KARGO, BAILEY RAE (OD)
Entity type:Individual
Prefix:DR
First Name:BAILEY
Middle Name:RAE
Last Name:KARGO
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:302 RAILROAD ST
Mailing Address - Street 2:
Mailing Address - City:WATER VALLEY
Mailing Address - State:MS
Mailing Address - Zip Code:38965-3032
Mailing Address - Country:US
Mailing Address - Phone:662-473-2181
Mailing Address - Fax:
Practice Address - Street 1:3045 HIGHWAY 51 S
Practice Address - Street 2:
Practice Address - City:SENATOBIA
Practice Address - State:MS
Practice Address - Zip Code:38668-6215
Practice Address - Country:US
Practice Address - Phone:662-562-5500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-26
Last Update Date:2025-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS1115152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist