MEDICARE: ROBERT H. BAKER

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	237700000X	Hearing Instrument Specialist	HADE000064	GA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1841269818
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROBERT H. BAKER

Provider Business Mailing Address
First Line	:	917 N INDIAN CREEK DR
Second Line	:	P.O. BOX 91
City	:	CLARKSTON
State	:	GA
Zip	:	30021-2245
Country	:	US
Telephone Number	:	404-299-1141
Fax Number	:	404-299-8195

Provider Business Practice Location Address
First Line	:	917 N INDIAN CREEK DR
Second Line	:
City	:	CLARKSTON
State	:	GA
Zip	:	30021-2245
Country	:	US
Telephone Number	:	404-299-1141
Fax Number	:	404-299-8195

Authorized Official
Title or Position	:	DISPENSER
Name	:	MR. JEFFREY H FARGASON
Credential	:
Telephone Number	:	404-299-1141

Provider Enumeration Date	:	03/14/2006
Last Update Date	:	06/13/2008

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