Healthcare Provider Details
I. General information
NPI: 1023109105
Provider Name (Legal Business Name): T SCOTT BAKER MD PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/27/2006
Last Update Date: 09/15/2025
Certification Date: 09/15/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1423 W BADDOUR PKWY
LEBANON TN
37087-3061
US
IV. Provider business mailing address
PO BOX 1165
LEBANON TN
37088-1165
US
V. Phone/Fax
- Phone: 615-257-0900
- Fax: 615-443-1444
- Phone: 615-257-0900
- Fax: 615-443-1444
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208100000X |
| Taxonomy | Physical Medicine & Rehabilitation Physician |
| License Number | MD31328 |
| License Number State | TN |
VIII. Authorized Official
Name:
T
SCOTT
BAKER
Title or Position: PRESIDENT
Credential: MD
Phone: 615-257-0900