Provider Demographics
NPI:1861191397
Name:BAUGHMAN, TIMOTHY HOWARD I
Entity type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:HOWARD
Last Name:BAUGHMAN
Suffix:I
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1840 E US HIGHWAY 36
Mailing Address - Street 2:
Mailing Address - City:URBANA
Mailing Address - State:OH
Mailing Address - Zip Code:43078-9600
Mailing Address - Country:US
Mailing Address - Phone:937-652-2834
Mailing Address - Fax:
Practice Address - Street 1:1840 E US HIGHWAY 36
Practice Address - Street 2:
Practice Address - City:URBANA
Practice Address - State:OH
Practice Address - Zip Code:43078-9600
Practice Address - Country:US
Practice Address - Phone:937-652-2834
Practice Address - Fax:937-652-2836
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-23
Last Update Date:2023-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH5523SC156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician