MEDICARE: TODD F BAKER MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207P00000X	Emergency Medicine Physician	15526R	LA
2	207P00000X	Emergency Medicine Physician	E-3581	AR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	5H828	OTHER	AR BLUE CROSS
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1801874698
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TODD F BAKER MD

Provider Business Mailing Address
First Line	:	PO BOX 32600
Second Line	:
City	:	SHREVEPORT
State	:	LA
Zip	:	71130-2600
Country	:	US
Telephone Number	:	318-212-4877
Fax Number	:	318-212-4192

Provider Business Practice Location Address
First Line	:	620 NORTH MAIN
Second Line	:
City	:	HARRISON
State	:	AR
Zip	:	72601-2926
Country	:	US
Telephone Number	:	870-365-2000
Fax Number	:	318-212-7505

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/03/2006
Last Update Date	:	05/14/2013

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Directions to “ TODD F BAKER MD” Practice Location

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