Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223S0112X | Oral and Maxillofacial Surgeon | 024890 | LA |
N | 204E00000X | Oral & Maxillofacial Surgeon | 024890 | LA |
NPI | 1275538191 |
---|---|
Provider Name | Dr. David Gunter Baughman |
First Address | Houma, LA 70360-6011 |
Second Address | Houma, LA 70360-6011 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/06/2005 |
Last Update Date | 06/05/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1850888 | (05) | LA |
H86608 | (02) |