Individual
JIMMY RAY BAUCUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
877 W FARIS RD, STE B, GREENVILLE, SC 29605-5608
(864) 455-6900
(864) 255-5619
Mailing address
1 INDEPENDENCE PT STE 212, GREENVILLE, SC 29615-4536
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
14065
SC
Other
Enumeration date
12/22/2005
Last updated
02/24/2020
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