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NPI Code Detail

MEDICARE: DR. JAY P BAKER DO

MEDICARE: DR. JAY P BAKER DO
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
1207L00000XAnesthesiology Physician36747MO
2207LP2900XPain Medicine (Anesthesiology) Physician36747MO
3208D00000XGeneral Practice Physician36747MO

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2P00189701OTHERRR MEDICARE

Other Identifiers

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

General Provider Information

NPI Number : 1972509974
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JAY P BAKER DO
Provider Business Mailing Address
First Line : 108 S HICKORY ST
Second Line :
City : MOUNT VERNON
State : MO
Zip : 65712-1407
Country : US
Telephone Number : 417-466-4110
Fax Number : 417-466-4255
Provider Business Practice Location Address
First Line : 1540 E EVERGREEN ST
Second Line :
City : SPRINGFIELD
State : MO
Zip : 65803-4300
Country : US
Telephone Number : 417-823-2900
Fax Number : 417-886-2774
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/23/2005
Last Update Date : 01/26/2024

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Directions to “ DR. JAY P BAKER DO” Practice Location

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