Organization
BRUCE BAUGHER D.O., PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRUCE EARL BAUGHER D.O. (PRESIDENT)
(580) 763-5900
Entity
Organization
Contact information
Practice address
1908 N 14TH ST, SUITE 207, PONCA CITY, OK 74601-2014
(580) 763-5900
(580) 763-5901
Mailing address
1908 N 14TH ST, SUITE 207, PONCA CITY, OK 74601-2014
(580) 763-5900
(580) 763-5901
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
4051
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200059980D
—
OK
01
—
446487280001
BLUE CROSS BLUE SHIELD
OK
01
—
7114671
AETNA
OK
01
—
P00252783
RAILROAD MEDICARE
OK
Enumeration date
11/21/2006
Last updated
04/27/2009
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