Healthcare Provider Details
I. General information
NPI: 1740439462
Provider Name (Legal Business Name): FRANKLIN HOBART BAKER PA
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 09/18/2008
Last Update Date: 05/13/2015
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
320 EAST MAIN STREET SUITE 200
CHATTANOOGA TN
37406
US
IV. Provider business mailing address
320 EAST MAIN STREET SUITE 200
CHATTANOOGA TN
37408
US
V. Phone/Fax
- Phone: 423-643-2246
- Fax: 423-643-2030
- Phone: 423-643-2246
- Fax: 423-643-2030
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363AM0700X |
| Taxonomy | Medical Physician Assistant |
| License Number | 50-002801 |
| License Number State | OH |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363AM0700X |
| Taxonomy | Medical Physician Assistant |
| License Number | PA2633 |
| License Number State | TN |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: