Healthcare Provider Details

I. General information

NPI: 1841253945
Provider Name (Legal Business Name): CAREY J. BAUGH NP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/10/2006
Last Update Date: 05/06/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4444 N 32ND ST SUITE 175
PHOENIX AZ
85018-3999
US

IV. Provider business mailing address

4444 N 32ND ST SUITE 175
PHOENIX AZ
85018-3999
US

V. Phone/Fax

Practice location:
  • Phone: 602-952-0002
  • Fax: 602-778-4565
Mailing address:
  • Phone: 602-952-0002
  • Fax: 602-778-4565

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN106929
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: