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General NPI Number Information
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NPI Number | 1003956459
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Entity Type | Organization
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Legal Business Name | NATHAN W BALDWIN MD PA
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Dates
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Enumeration Date | 02/07/2007
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Last Update Date | 11/03/2010
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Provider Practice Location Address
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Address Line | 100 HOSPITAL ST SUITE 100
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City | BOONEVILLE
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State | MS
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Zip | 38829-3354
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Country | US
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Telephone | 662-820-1600
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Fax | 662-720-1664
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Provider Business Mailing Address
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Address Line | 100 HOSPITAL ST STE 100 P. O. BOX 70
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City | BOONEVILLE
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State | MS
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Zip | 38829-3354
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Country | US
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Telephone | 662-720-1600
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Fax | 662-720-1172
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Authorized Official
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Title or Position | PHYSICIAN
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Name | NATHAN WARD BALDWIN
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Credential | MD
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Telephone | 662-720-1600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 15031
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License Number State | MS
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 15031
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License Number State | MS
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