Healthcare Provider Details

I. General information

NPI: 1144267535
Provider Name (Legal Business Name): CHRISTOPHER O. BALDWIN M.D.,LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/02/2006
Last Update Date: 05/19/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

604B W 6TH ST
ROLLA MO
65401-2941
US

IV. Provider business mailing address

604B W 6TH ST
ROLLA MO
65401-2941
US

V. Phone/Fax

Practice location:
  • Phone: 573-426-6588
  • Fax: 573-426-5664
Mailing address:
  • Phone: 573-426-6588
  • Fax: 573-426-5664

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number2006005743
License Number StateMO

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: MR. CHRISTOPHER OWSLEY BALDWIN
Title or Position: PHYSICIAN/OWNER
Credential: MD
Phone: 573-426-6588