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General NPI Number Information
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NPI Number | 1013088947
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Entity Type | Individual
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Provider Name | BRENDA JOAN BAKER MD
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Gender | Female
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Dates
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Enumeration Date | 11/13/2006
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Last Update Date | 11/20/2018
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Provider Practice Location Address
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Address Line | BUILDING 37 HIGHWAY 343
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City | NEON
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State | KY
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Zip | 41840
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Country | US
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Telephone | 606-832-0192
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Fax | 606-832-0194
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Provider Business Mailing Address
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Address Line | PO BOX 517
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City | NEON
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State | KY
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Zip | 41840
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Country | US
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Telephone | 606-832-0192
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Fax | 606-832-0194
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 29340
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License Number State | KY
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