MEDICARE: DR. RONNEY GENE BALDWIN D.C.

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	111N00000X	Chiropractor	08001587A	IN

General Provider Information

NPI Number	:	1356412365
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RONNEY GENE BALDWIN D.C.

Provider Business Mailing Address
First Line	:	301 FULTON AVE
Second Line	:
City	:	ROCHESTER
State	:	IN
Zip	:	46975-1227
Country	:	US
Telephone Number	:	574-223-2670
Fax Number	:

Provider Business Practice Location Address
First Line	:	1415 MAIN ST
Second Line	:
City	:	ROCHESTER
State	:	IN
Zip	:	46975-2109
Country	:	US
Telephone Number	:	574-223-5111
Fax Number	:	574-224-5111

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

Provider Enumeration Date	:	11/13/2006
Last Update Date	:	07/08/2007

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