MEDICARE: BAGGETT & BAGGETT DPM, PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213E00000X	Podiatrist	P00000663	GA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1457508673
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BAGGETT & BAGGETT DPM, PC

Provider Business Mailing Address
First Line	:	PO BOX 5342
Second Line	:
City	:	VALDOSTA
State	:	GA
Zip	:	31603-5342
Country	:	US
Telephone Number	:	229-560-8848
Fax Number	:	229-241-0870

Provider Business Practice Location Address
First Line	:	1801 N LEE ST.
Second Line	:
City	:	VALDOSTA
State	:	GA
Zip	:	31603-5342
Country	:	US
Telephone Number	:	229-560-8848
Fax Number	:	229-241-0870

Authorized Official
Title or Position	:	PRESIDENT/OWNER
Name	:	BARTON DEAN BAGGETT
Credential	:	D.P.M.
Telephone Number	:	229-560-8848

Provider Enumeration Date	:	08/19/2008
Last Update Date	:	08/19/2008

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