Provider Demographics
NPI:1306878806
Name:BAUMGARTNER, JAMES (MD)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:
Last Name:BAUMGARTNER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:615 E PRINCETON ST
Mailing Address - Street 2:SUITE 540
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32803-1456
Mailing Address - Country:US
Mailing Address - Phone:407-236-0006
Mailing Address - Fax:407-236-0007
Practice Address - Street 1:615 E PRINCETON ST
Practice Address - Street 2:SUITE 540
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32803-1456
Practice Address - Country:US
Practice Address - Phone:407-236-0006
Practice Address - Fax:407-236-0007
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2013-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ2492207T00000X
FLME110809207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX138323414Medicaid
FL14J12OtherBCBS
OK100059870AOtherOKLAHOMA MEDICAID
TX8W5624OtherBCBS
TX138323415OtherCSHCN MEDICAID
FL003974300Medicaid
TX138323414Medicaid
FL003974300Medicaid