MEDICARE: ADRIENNE BAUGH OT

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	225X00000X	Occupational Therapist	TA2802	MS

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	:	1487093811
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ADRIENNE BAUGH OT

Provider Business Mailing Address
First Line	:	PO BOX 674
Second Line	:
City	:	MORTON
State	:	MS
Zip	:	39117
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1151 HIGHWAY 35 S
Second Line	:
City	:	FOREST
State	:	MS
Zip	:	39074-8829
Country	:	US
Telephone Number	:	601-469-2732
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/19/2013
Last Update Date	:	02/17/2020

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Directions to “ ADRIENNE BAUGH OT” Practice Location

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