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General NPI Number Information
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NPI Number | 1972382497
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Entity Type | Individual
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Provider Name | BALEIGH MCDANIEL
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Gender | Female
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Dates
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Enumeration Date | 09/25/2023
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Last Update Date | 07/28/2025
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Provider Practice Location Address
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Address Line | 307 HOLLOWAY RD
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City | THOMASTON
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State | GA
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Zip | 30286-4448
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Country | US
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Telephone | 706-975-3708
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Fax |
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Provider Business Mailing Address
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Address Line | 5665 NEW NORTHSIDE DR STE 320
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City | ATLANTA
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State | GA
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Zip | 30328-5834
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Country | US
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Telephone | 770-874-5400
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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