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General NPI Number Information
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NPI Number | 1700048477
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Entity Type | Individual
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Provider Name | DALE EUGENE BAUGHMAN CRNA
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Gender | Male
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Dates
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Enumeration Date | 06/25/2008
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Last Update Date | 01/16/2024
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Provider Practice Location Address
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Address Line | 1 CHOCTAW WAY
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City | TALIHINA
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State | OK
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Zip | 74571-2022
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Country | US
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Telephone | 918-567-7000
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1263
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City | TALIHINA
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State | OK
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Zip | 74571-1263
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Country | US
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Telephone | 918-567-7000
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP0904X
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Taxonomy Name | Federal Public Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 69416
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License Number State | OK
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