MEDICARE: JONATHAN MARTIN BALDWIN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207V00000X	Obstetrics & Gynecology Physician	21802	OK

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	800522535	OTHER	OK	MEDICARE GROUP PIN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1255384988
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JONATHAN MARTIN BALDWIN MD

Provider Business Mailing Address
First Line	:	6600 S YALE AVE STE 1200
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74136-3333
Country	:	US
Telephone Number	:
Fax Number	:	918-392-4465

Provider Business Practice Location Address
First Line	:	3504 W OKMULGEE ST
Second Line	:
City	:	MUSKOGEE
State	:	OK
Zip	:	74401-5073
Country	:	US
Telephone Number	:	918-686-5399
Fax Number	:	918-684-3229

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/17/2006
Last Update Date	:	05/04/2026

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