Healthcare Provider Details

I. General information

NPI: 1679688956
Provider Name (Legal Business Name): LEIGH BAKER DO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/20/2006
Last Update Date: 08/29/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

74 LUNT ROAD SUITE 204
FALMOUTH ME
04105
US

IV. Provider business mailing address

PO BOX 1778
LEWISTON ME
04241-1778
US

V. Phone/Fax

Practice location:
  • Phone: 207-846-7666
  • Fax: 207-781-4098
Mailing address:
  • Phone: 207-375-3024
  • Fax: 207-375-3026

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberDO1224
License Number StateME
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number1224
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: