MR. MAX RUSSELL BALDWIN JR. (NPI# 1316028467) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316028467 |
| Entity Type | Individual |
| Full Name | MR. MAX RUSSELL BALDWIN JR. |
| Credential | PAC |
| Practice Address |
611 E. Villanow St. Lafayette GA 30728 |
| Practice Telephone | 7066381606 |
| Practice Fax Number | 7066389987 |
| Mailing Telephone | 7066381606 |
| Mailing Fax Number | 7066389987 |
| Enumeration Date | 2006-10-17 |
| Last Update Date | 2013-12-19 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 003194 | GA | Allopathic & Osteopathic Physicians |
| Street Address |
611 E. VILLANOW ST. |
| City | LAFAYETTE |
| State | GA |
| Zip Code | 30728 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891395620 | Primary Health Care Center of Dade, Inc. | Clinic/Center | 8a Probasco Street Unit 214, Lafayette, GA 30728 | 2020-10-30 |
| 1891358750 | K -va -t Food Stores Inc | Durable Medical Equipment & Medical Supplies | 311 North Main Street, Lafayette, GA 30728 | 2019-04-17 |
| 1023505914 | Heather Staton | Pharmacist | 324 W. Patton Street, Lafayette, GA 30728 | 2018-04-17 |
| 1023484805 | Tyler Kellum Levie | Dentist | 201 E. Villanow Street, Lafayette, GA 30728 | 2015-08-17 |
| 1083987481 | Krishawna Elaine Montgomery | Counselor | 501 Mize Street Lookout Mountain Community Services, Lafayette, GA 30728 | 2012-02-15 |
| 1346518198 | William Randall Smith | Behavioral Analyst | 902 Daugherty Street, Lafayette, GA 30728 | 2011-12-08 |
| 1821321506 | John H Rockwell | Contractor | 143 Golden Oaks Dr, La Fayette, GA 30728 | 2009-09-11 |
| 1619113057 | Lookout Mountain Community Services | Community/Behavioral Health | 43 Shady Court, Lafayette, GA 30728 | 2009-01-06 |
| 1326212705 | Lookout Mountain Community Services | Community/Behavioral Health | 1218 Chattanooga St., Lafayette, GA 30728 | 2008-04-17 |
| 1649444084 | Lookout Mountain Community Services | Community/Behavioral Health | 29 Mae Tucker Rd., Lafayette, GA 30728 | 2008-04-16 |
| Find all providers in zip 30728 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568060135 | Audubon Family Medicine LLC | Family Medicine | 2301 Moss St, Lafayette, LA 70501-2125 | 2020-10-15 |
| 1871116244 | Partners In Primary Care La PC | Family Medicine | 537 Bertrand Dr Ste F0a, Lafayette, LA 70506-5556 | 2020-05-20 |
| 1013471259 | Courtney Cobb | Family Medicine | 500 Juliette Pl, Lafayette, LA 70506-4571 | 2019-01-22 |
| 1538672993 | Pamela Rene Roeder | Family Medicine | 8196 N 1000 E, Lafayette, IN 47905-9742 | 2017-11-08 |
| 1790297935 | Diamond Medical Group | Family Medicine | 830 Park East Blvd, Lafayette, IN 47905-0778 | 2017-10-27 |
| 1780114074 | Mimi Nguyen | Family Medicine | 4212 W Congress St Ste 1600, Lafayette, LA 70506-6767 | 2017-06-19 |
| 1679922249 | Lafayette Health Ventures, Inc | Family Medicine | 917 W Gloria Switch Road, Lafayette, LA 70507-2309 | 2016-06-06 |
| 1003278854 | Rebecca Lynn Currier Curran | Family Medicine | 2932 Ambassador Caffery Parkway, Lafayette, LA 70506 | 2016-03-22 |
| 1871989244 | Justin Matthew Pratt | Family Medicine | 1630 Rue Du Belier Apt 1307, Lafayette, LA 70506 | 2015-04-12 |
| 1558761973 | A. Elaine Ashby, M.d., Inc. | Family Medicine | 3732 Mt Diablo Blvd Ste 385, Lafayette, CA 94549-3625 | 2014-09-04 |
| Find all providers in LAFAYETTE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.