Provider Demographics
NPI:1811175763
Name:THOMAS JAMES BADEN
Entity type:Organization
Organization Name:THOMAS JAMES BADEN
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:J
Authorized Official - Last Name:BADEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:828-438-4683
Mailing Address - Street 1:111 FOOTHILLS DR
Mailing Address - Street 2:
Mailing Address - City:MORGANTON
Mailing Address - State:NC
Mailing Address - Zip Code:28655-5123
Mailing Address - Country:US
Mailing Address - Phone:828-438-4683
Mailing Address - Fax:
Practice Address - Street 1:111 FOOTHILLS DR
Practice Address - Street 2:
Practice Address - City:MORGANTON
Practice Address - State:NC
Practice Address - Zip Code:28655-5123
Practice Address - Country:US
Practice Address - Phone:828-438-4683
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-02
Last Update Date:2008-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
230482Medicare PIN