Healthcare Provider Details

I. General information

NPI: 1225006794
Provider Name (Legal Business Name): JOHN E BAKER DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/10/2006
Last Update Date: 04/16/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6317 SEALAWN DR
SPRING HILL FL
34607-2638
US

IV. Provider business mailing address

6317 SEALAWN DR
SPRING HILL FL
34607-2638
US

V. Phone/Fax

Practice location:
  • Phone: 352-597-2223
  • Fax: 352-597-2061
Mailing address:
  • Phone: 352-597-2223
  • Fax: 352-597-2061

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberPO2324
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: