Individual
MADELYN A BAUCUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1220 JEFFERSON ST, LAUREL, MS 39440-4355
(601) 426-4000
(601) 426-4105
Mailing address
PO BOX 247, LAUREL, MS 39441-0247
(601) 399-6169
(601) 399-6262
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA00335
MS
Other
Enumeration date
08/08/2017
Last updated
08/08/2017
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