Individual
JON TODD BAUGHMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PAC
Contact information
Practice address
11495 CALLISON STREET, LIFE HOUSE COMMUNITY HEALTH CENTER, SUTTON, AK 99674-0000
(907) 631-7665
Mailing address
PO BOX 4363, 870 HERON DRIVE, PAGE, AZ 86040-4363
(928) 660-1337
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA20020040
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
442226
—
AZ
Enumeration date
10/05/2006
Last updated
03/03/2016
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