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General NPI Number Information
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NPI Number | 1740373026
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Entity Type | Individual
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Provider Name | JOHN WILLIAM BALDWIN O.D.
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Gender | Male
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Dates
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Enumeration Date | 10/01/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1569 N EXPRESSWAY
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City | GRIFFIN
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State | GA
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Zip | 30223-1746
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Country | US
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Telephone | 770-233-6860
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Fax |
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Provider Business Mailing Address
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Address Line | 1118 HILLTOP DR
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City | GRIFFIN
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State | GA
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Zip | 30224-4937
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Country | US
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Telephone | 770-233-6860
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152WC0802X
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Taxonomy Name | Corneal and Contact Management Optometrist
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License Number | 819T
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License Number State | GA
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