Provider Demographics
NPI:1871559708
Name:BAUMANN, ERIC (MD)
Entity type:Individual
Prefix:
First Name:ERIC
Middle Name:
Last Name:BAUMANN
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 1:2100 CENTERPOINTE WEST DR
Mailing Address - Street 2:
Mailing Address - City:PRESCOTT
Mailing Address - State:AZ
Mailing Address - Zip Code:86301-8487
Mailing Address - Country:US
Mailing Address - Phone:928-717-0788
Mailing Address - Fax:928-717-0748
Practice Address - Street 1:2100 CENTERPOINTE WEST DR
Practice Address - Street 2:
Practice Address - City:PRESCOTT
Practice Address - State:AZ
Practice Address - Zip Code:86301-8487
Practice Address - Country:US
Practice Address - Phone:928-717-0788
Practice Address - Fax:928-717-0748
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-20
Last Update Date:2012-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ340592081P2900X, 208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
No208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ105250Medicare ID - Type Unspecified
AZH56857Medicare UPIN