MEDICARE: TRAVIS BAUGHMAN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	14439	OK

General Provider Information

NPI Number	:	1982060711
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TRAVIS BAUGHMAN

Provider Business Mailing Address
First Line	:	185 E 33RD ST
Second Line	:
City	:	EDMOND
State	:	OK
Zip	:	73013-4602
Country	:	US
Telephone Number	:	580-512-2559
Fax Number	:

Provider Business Practice Location Address
First Line	:	185 E 33RD ST
Second Line	:
City	:	EDMOND
State	:	OK
Zip	:	73013-4602
Country	:	US
Telephone Number	:	405-741-0857
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/08/2016
Last Update Date	:	12/19/2022

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Directions to “ TRAVIS BAUGHMAN ” Practice Location

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