Organization
BALDWIN EYE CARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TREVOR J BALDWIN OD (OPTOMETRIST/OWNER)
(608) 837-7325
Entity
Organization
Contact information
Practice address
1721 W MAIN ST, SUN PRAIRIE, WI 53590-3161
(608) 837-7325
(608) 837-7326
Mailing address
1721 W MAIN ST, SUN PRAIRIE, WI 53590-3161
(608) 837-7325
(608) 837-7326
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
152WC0802X
Corneal and Contact Management Optometrist
—
—
156FX1201X
Optometric Assistant Technician
—
—
156FX1800X
Optician
—
—
261Q00000X
Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000047780
MEDICARE GROUP NUMBER
—
Enumeration date
09/26/2007
Last updated
02/22/2021
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