Provider Demographics
NPI:1417118423
Name:BAUMGARDNER, PAUL DAVID (DC)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:DAVID
Last Name:BAUMGARDNER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2663 AIRPORT PULLING RD S
Mailing Address - Street 2:D-104
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34112-4875
Mailing Address - Country:US
Mailing Address - Phone:239-793-3200
Mailing Address - Fax:
Practice Address - Street 1:2663 AIRPORT PULLING RD S
Practice Address - Street 2:D-104
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34112-4875
Practice Address - Country:US
Practice Address - Phone:239-793-3200
Practice Address - Fax:239-793-0756
Is Sole Proprietor?:No
Enumeration Date:2008-06-23
Last Update Date:2013-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH 9592111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor