Healthcare Provider Details

I. General information

NPI: 1104837327
Provider Name (Legal Business Name): THOMAS SCOTT BAKER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: T. SCOTT BAKER M.D.

II. Dates (important events)

Enumeration Date: 08/11/2006
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

Practice location:
  • Phone: 615-257-0900
  • Fax: 615-443-1444
Mailing address:
  • Phone: 615-257-0900
  • Fax: 615-443-1444

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License NumberMD0003132
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: