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General NPI Number Information
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NPI Number | 1558470567
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Entity Type | Organization
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Legal Business Name | BALDWIN FAMILY HEALTH CARE
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Dates
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Enumeration Date | 08/30/2006
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Last Update Date | 11/12/2020
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Provider Practice Location Address
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Address Line | 1035 E WILCOX AVE
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City | WHITE CLOUD
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State | MI
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Zip | 49349-8794
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Country | US
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Telephone | 231-689-5943
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Fax | 231-689-1590
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Provider Business Mailing Address
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Address Line | 1615 MICHIGAN AVE
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City | BALDWIN
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State | MI
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Zip | 49304-7984
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Country | US
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Telephone | 231-745-2743
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Fax | 231-745-3690
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Authorized Official
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Title or Position | CEO
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Name | MS. JULIE TATKO
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Credential |
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Telephone | 231-745-2743
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QF0400X
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Taxonomy Name | Federally Qualified Health Center (FQHC)
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License Number |
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License Number State |
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