Provider Demographics
NPI:1063734556
Name:BAUMGARNER, GENE THOMAS (MD)
Entity type:Individual
Prefix:DR
First Name:GENE
Middle Name:THOMAS
Last Name:BAUMGARNER
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3986 MIRROR POND WAY
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97408-5954
Mailing Address - Country:US
Mailing Address - Phone:541-345-9068
Mailing Address - Fax:541-345-9068
Practice Address - Street 1:3986 MIRROR POND WAY
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97408-5954
Practice Address - Country:US
Practice Address - Phone:541-345-9068
Practice Address - Fax:541-345-9068
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-24
Last Update Date:2010-02-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WAMD 00039393208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology