Healthcare Provider Details

I. General information

NPI: 1285208470
Provider Name (Legal Business Name): TAYLOR DOUGLAS BAKER DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/13/2021
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3609 SW DURHAM DR
DURHAM NC
27707-6507
US

IV. Provider business mailing address

3609 SW DURHAM DR
DURHAM NC
27707-6507
US

V. Phone/Fax

Practice location:
  • Phone: 919-471-9622
  • Fax: 919-477-1929
Mailing address:
  • Phone: 919-471-9622
  • Fax: 919-477-1929

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number2025-00620
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License Number2025-00620
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: