Provider Demographics
NPI:1093209538
Name:BAUGUSS, HALEY (PA-C)
Entity Type:Individual
Prefix:
First Name:HALEY
Middle Name:
Last Name:BAUGUSS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 OGLETHORPE AVE # C7
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:GA
Mailing Address - Zip Code:30606-2221
Mailing Address - Country:US
Mailing Address - Phone:706-425-9445
Mailing Address - Fax:
Practice Address - Street 1:700 OGLETHORPE AVE # C7
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:GA
Practice Address - Zip Code:30606-2221
Practice Address - Country:US
Practice Address - Phone:706-425-9445
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-19
Last Update Date:2024-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA8810363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical