MEDICARE: LOOK BALDWIN LLC

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	152W00000X	Optometrist
2	122300000X	Dentist

General Provider Information

NPI Number	:	1902399256
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LOOK BALDWIN LLC

Provider Business Mailing Address
First Line	:	1651 SCHILLINGER RD N
Second Line	:
City	:	SEMMES
State	:	AL
Zip	:	36575-7409
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4751 MAIN ST STE F217
Second Line	:
City	:	ORANGE BEACH
State	:	AL
Zip	:	36561-5862
Country	:	US
Telephone Number	:	251-301-9690
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR OF OPERATIONS
Name	:	BROOK GRIFFIN
Credential	:
Telephone Number	:	251-301-9690

Provider Enumeration Date	:	06/12/2018
Last Update Date	:	06/12/2018

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Directions to “LOOK BALDWIN LLC ” Practice Location

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