Healthcare Provider Details

I. General information

NPI: 1710161237
Provider Name (Legal Business Name): JOHN E BAKER DPM PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/19/2007
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 Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License NumberPO2324
License Number StateFL

VIII. Authorized Official

Name: DR. JOHN E BAKER
Title or Position: PHYSICIAN
Credential: DPM
Phone: 352-597-2223