Provider Demographics
NPI:1144267535
Name:CHRISTOPHER O. BALDWIN M.D.,LLC
Entity type:Organization
Organization Name:CHRISTOPHER O. BALDWIN M.D.,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:OWSLEY
Authorized Official - Last Name:BALDWIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:573-426-6588
Mailing Address - Street 1:604B W 6TH ST
Mailing Address - Street 2:
Mailing Address - City:ROLLA
Mailing Address - State:MO
Mailing Address - Zip Code:65401-2941
Mailing Address - Country:US
Mailing Address - Phone:573-426-6588
Mailing Address - Fax:573-426-5664
Practice Address - Street 1:604B W 6TH ST
Practice Address - Street 2:
Practice Address - City:ROLLA
Practice Address - State:MO
Practice Address - Zip Code:65401-2941
Practice Address - Country:US
Practice Address - Phone:573-426-6588
Practice Address - Fax:573-426-5664
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-02
Last Update Date:2022-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2006005743207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOA83035Medicare UPIN