Provider Demographics
NPI:1912562695
Name:BAUGH, ANTHONY JASON (PA-C)
Entity Type:Individual
Prefix:
First Name:ANTHONY
Middle Name:JASON
Last Name:BAUGH
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 ARNOLD CT
Mailing Address - Street 2:
Mailing Address - City:TRAVIS AFB
Mailing Address - State:CA
Mailing Address - Zip Code:94535-1300
Mailing Address - Country:US
Mailing Address - Phone:210-562-0890
Mailing Address - Fax:
Practice Address - Street 1:2475 BROAD ST
Practice Address - Street 2:
Practice Address - City:SUMTER
Practice Address - State:SC
Practice Address - Zip Code:29150-1820
Practice Address - Country:US
Practice Address - Phone:803-778-6555
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-07
Last Update Date:2020-04-20
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant