Provider Demographics
NPI:1992830053
Name:BALDWIN, ERIC JAMES (DC)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:JAMES
Last Name:BALDWIN
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 1:5021 ATWOOD DR
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:KY
Mailing Address - Zip Code:40475-8898
Mailing Address - Country:US
Mailing Address - Phone:859-625-5777
Mailing Address - Fax:859-625-5788
Practice Address - Street 1:5021 ATWOOD DR
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:KY
Practice Address - Zip Code:40475-8898
Practice Address - Country:US
Practice Address - Phone:859-625-5777
Practice Address - Fax:859-625-5788
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-22
Last Update Date:2022-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4368111N00000X
KY250739111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY85000610Medicaid
KY85000610Medicaid
6087501Medicare ID - Type Unspecified