Provider Demographics
NPI:1629141833
Name:BALDWIN, SARAH SUTHERLAND (OD)
Entity Type:Individual
Prefix:DR
First Name:SARAH
Middle Name:SUTHERLAND
Last Name:BALDWIN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3563 TOM AUSTIN HWY
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:TN
Mailing Address - Zip Code:37172-3939
Mailing Address - Country:US
Mailing Address - Phone:615-384-5225
Mailing Address - Fax:615-384-1331
Practice Address - Street 1:3563 TOM AUSTIN HWY
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:TN
Practice Address - Zip Code:37172-3939
Practice Address - Country:US
Practice Address - Phone:615-384-5225
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-16
Last Update Date:2023-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNOD2463152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1763901OtherCIGNA
TN3943986OtherMEDICARE GROUP NUMBER
TN4092212OtherBLUE CROSS BLUE SHIELD
TN3946158Medicaid
TNU98383OtherHEALTHSPRING
TN410038166OtherPALMETTO GBA-RR MEDICARE
TN9478853OtherPHCS NETWORK
TN1763901OtherCIGNA
TN3943986OtherMEDICARE GROUP NUMBER
TN3946158Medicare PIN