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General NPI Number Information
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NPI Number | 1730620410
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Entity Type | Individual
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Provider Name | JOE BAUGHAM PA-C
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Gender | Male
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Dates
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Enumeration Date | 03/15/2017
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Last Update Date | 09/02/2022
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Provider Practice Location Address
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Address Line | 113 W HANSELL ST
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City | THOMASVILLE
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State | GA
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Zip | 31792-6664
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Country | US
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Telephone | 229-226-3060
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Fax | 855-460-8658
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Provider Business Mailing Address
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Address Line | 3334 CAPITAL MEDICAL BLVD STE 400
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City | TALLAHASSEE
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State | FL
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Zip | 32308-4470
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Country | US
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Telephone | 850-877-8174
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Fax | 844-261-6839
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA9114730
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 008291
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License Number State | GA
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