Healthcare Provider Details

I. General information

NPI: 1124244017
Provider Name (Legal Business Name): DONALD R BAKER RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/18/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

803 MEYERS BAKER RD STE 110
LONDON KY
40741-3041
US

IV. Provider business mailing address

1619 SENATOR LN
LONDON KY
40741-2621
US

V. Phone/Fax

Practice location:
  • Phone: 606-877-1008
  • Fax: 606-864-3127
Mailing address:
  • Phone: 606-877-2328
  • Fax: 606-864-3127

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number008444
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: