Healthcare Provider Details

I. General information

NPI: 1134743297
Provider Name (Legal Business Name): WILLIAM FULLER BAKER D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/04/2020
Last Update Date: 06/04/2026
Certification Date: 06/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

538 N QUEEN ST
LANCASTER PA
17603-3046
US

IV. Provider business mailing address

538 N QUEEN ST
LANCASTER PA
17603-3046
US

V. Phone/Fax

Practice location:
  • Phone: 717-393-1900
  • Fax:
Mailing address:
  • Phone: 856-566-6853
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberOS025806
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: