Provider Demographics
NPI:1588845184
Name:BAUCOM, CATHERINE CLAYTON (MD/PHD)
Entity Type:Individual
Prefix:DR
First Name:CATHERINE
Middle Name:CLAYTON
Last Name:BAUCOM
Suffix:
Gender:F
Credentials:MD/PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:541 SHADOWS LN STE C
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70806-6559
Mailing Address - Country:US
Mailing Address - Phone:225-755-3070
Mailing Address - Fax:225-755-3085
Practice Address - Street 1:541 SHADOWS LN STE C
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70806-6559
Practice Address - Country:US
Practice Address - Phone:225-755-3070
Practice Address - Fax:225-755-3085
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-25
Last Update Date:2020-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA39208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery