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General NPI Number Information
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NPI Number | 1184639908
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Entity Type | Organization
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Legal Business Name | LEONARD A BAUGHAM SR MD, PLLC
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Dates
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Enumeration Date | 07/30/2006
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Last Update Date | 07/16/2008
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Provider Practice Location Address
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Address Line | 408 8TH ST
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City | NORTH WILKESBORO
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State | NC
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Zip | 28659-4167
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Country | US
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Telephone | 336-667-5924
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Fax | 336-667-4303
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Provider Business Mailing Address
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Address Line | PO BOX 1146
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City | NORTH WILKESBORO
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State | NC
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Zip | 28659-1146
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Country | US
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Telephone | 336-667-5924
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Fax | 336-667-4303
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. ANGIE MARIE ROE
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Credential |
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Telephone | 336-667-5924
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 20998
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License Number State | NC
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