Charles    Gordon    MD
Contract Details
Baldwin Bone & Joint, PC
Facility name
Provider ID
P000009211
NPI
1275825135
Tax ID
631283588
Effective Date
10/1/2001
Last Updated
7/29/2021
Direct Contract
Yes
Term Date
7/27/2021
Status
Contract Discounts
Discount Type
M
Exhibit ID
AM_448
Location Details
Address
1505 Daphne Avenue
Daphne, AL 36526
United States
County
Baldwin
Phone
2516252663 (Phone)
Billing Details
Address
1505 Daphne Avenue
Daphne, AL 36526
Billing Phone
2516252663
Specialty Type
Surgery, Orthopedic Spine
Map
Address