| Doctor Name: | CLAIRALYN LOIS BAUCOM |
| NPI Number: | 1760569339 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MD |
| License Number: | 0101240222 |
| Business Practice Address: | Kadena Pediatric Clinic 18mdg / Sghq Unit 5142 Apo, AP - 963675142 |
| Business Phone Number: | 3156304542 |
| Business Fax Number: | |
| Mailing Address: | 18mdos, Psc 80 Box 15477 APO |
| State: | AP |
| Postal Code: | 963675142 |
| Phone Number: | 3156304542 |
| Fax Number: | |
| NPI Enumeration Date: | 11/01/2006 |
| NPI Last Update Date: | 09/11/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 0101240222 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | VA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |