Provider Demographics
NPI:1023384187
Name:INMAN AND BALDWIN ORTHODONTICS
Entity Type:Organization
Organization Name:INMAN AND BALDWIN ORTHODONTICS
Other - Org Name:INMAN ORTHODONTICS
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:KEITH
Authorized Official - Last Name:INMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:270-769-1349
Mailing Address - Street 1:520 N MILES ST
Mailing Address - Street 2:
Mailing Address - City:ELIZABETHTOWN
Mailing Address - State:KY
Mailing Address - Zip Code:42701-1874
Mailing Address - Country:US
Mailing Address - Phone:270-769-1349
Mailing Address - Fax:270-769-4605
Practice Address - Street 1:520 N MILES ST
Practice Address - Street 2:
Practice Address - City:ELIZABETHTOWN
Practice Address - State:KY
Practice Address - Zip Code:42701-1874
Practice Address - Country:US
Practice Address - Phone:270-769-1349
Practice Address - Fax:270-769-4605
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-22
Last Update Date:2012-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100117970Medicaid