Provider Demographics
NPI:1407490980
Name:BAUGHMAN, COREY JOE
Entity Type:Individual
Prefix:MR
First Name:COREY
Middle Name:JOE
Last Name:BAUGHMAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:805 N FRONT ST
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17102-3409
Mailing Address - Country:US
Mailing Address - Phone:717-232-2027
Mailing Address - Fax:
Practice Address - Street 1:805 N FRONT ST
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17102-3409
Practice Address - Country:US
Practice Address - Phone:717-232-2027
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-29
Last Update Date:2019-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator