Individual
BAYLEE RICHARDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
107 CHURCH ST, BELZONI, MS 39038-3929
(662) 247-2105
(662) 247-4849
Mailing address
1362 LAKE WASHINGTON RD E, GLEN ALLAN, MS 38744-9748
(601) 405-9047
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
PA00703
MS
Other
Enumeration date
02/16/2023
Last updated
02/16/2023
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