Provider Demographics
NPI:1831304369
Name:BAUGH, BRYANT DEQUAN (MESS, ATC,)
Entity Type:Individual
Prefix:MR
First Name:BRYANT
Middle Name:DEQUAN
Last Name:BAUGH
Suffix:
Gender:M
Credentials:MESS, ATC,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2045 PEACHTREE RD NE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30309-1414
Mailing Address - Country:US
Mailing Address - Phone:404-355-0743
Mailing Address - Fax:404-603-9887
Practice Address - Street 1:2045 PEACHTREE RD NE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30309-1414
Practice Address - Country:US
Practice Address - Phone:404-355-0743
Practice Address - Fax:404-603-9887
Is Sole Proprietor?:No
Enumeration Date:2007-05-10
Last Update Date:2011-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer