Provider Demographics
NPI:1457455586
Name:BALDWIN, JOHN BARROW (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:BARROW
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 1:426 CODELL DRIVE
Mailing Address - Street 2:SUITE 1
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40509-0157
Mailing Address - Country:US
Mailing Address - Phone:859-268-8143
Mailing Address - Fax:859-268-8143
Practice Address - Street 1:426 CODELL DRIVE
Practice Address - Street 2:SUITE 1
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40509-0157
Practice Address - Country:US
Practice Address - Phone:859-268-8143
Practice Address - Fax:859-268-8143
Is Sole Proprietor?:No
Enumeration Date:2006-09-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY16045207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
C72241Medicare UPIN
KY1256401Medicare ID - Type Unspecified