Provider Demographics
NPI:1083680011
Name:BALDWIN, JAMES LESTER (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:LESTER
Last Name:BALDWIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5050 NE HOYT
Mailing Address - Street 2:#138
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97213
Mailing Address - Country:US
Mailing Address - Phone:503-223-1584
Mailing Address - Fax:503-241-8362
Practice Address - Street 1:5050 NE HOYT
Practice Address - Street 2:#138
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97213
Practice Address - Country:US
Practice Address - Phone:503-223-1584
Practice Address - Fax:503-241-8362
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD07439207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR051867Medicaid
OR0000BHFSHMedicare ID - Type Unspecified
OR051867Medicaid