Provider Demographics
NPI:1336129741
Name:BAUGHER, JOAN MARIE (PMAC)
Entity Type:Individual
Prefix:
First Name:JOAN
Middle Name:MARIE
Last Name:BAUGHER
Suffix:
Gender:F
Credentials:PMAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 526
Mailing Address - Street 2:
Mailing Address - City:BIGLERVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17307
Mailing Address - Country:US
Mailing Address - Phone:717-677-9288
Mailing Address - Fax:717-677-4196
Practice Address - Street 1:23 N MAIN ST
Practice Address - Street 2:
Practice Address - City:BIGLERVILLE
Practice Address - State:PA
Practice Address - Zip Code:17307
Practice Address - Country:US
Practice Address - Phone:717-677-9288
Practice Address - Fax:717-677-4196
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes211D00000XPodiatric Medicine & Surgery Service ProvidersAssistant, Podiatric
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA2689OtherPP MAA