Provider Demographics
NPI:1790954345
Name:BALDWIN INTERNAL MEDICINE ASSOCIATES
Entity Type:Organization
Organization Name:BALDWIN INTERNAL MEDICINE ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INSURANCE CLERK
Authorized Official - Prefix:MRS
Authorized Official - First Name:JANICE
Authorized Official - Middle Name:J
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:251-990-5055
Mailing Address - Street 1:374 S GREENO RD
Mailing Address - Street 2:
Mailing Address - City:FAIRHOPE
Mailing Address - State:AL
Mailing Address - Zip Code:36532-1916
Mailing Address - Country:US
Mailing Address - Phone:251-990-5055
Mailing Address - Fax:251-990-5928
Practice Address - Street 1:374 S GREENO RD
Practice Address - Street 2:
Practice Address - City:FAIRHOPE
Practice Address - State:AL
Practice Address - Zip Code:36532-1916
Practice Address - Country:US
Practice Address - Phone:251-990-5055
Practice Address - Fax:251-990-5928
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-28
Last Update Date:2008-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL14135207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL000029294Medicaid
ALG583Medicare PIN
AL000029294Medicaid
AL000029294Medicare PIN