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General NPI Number Information
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NPI Number | 1235371931
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Entity Type | Individual
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Provider Name | KENNETH M BAKER M.D.
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Gender | Male
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Dates
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Enumeration Date | 03/27/2009
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Last Update Date | 03/27/2009
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Provider Practice Location Address
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Address Line | 1901 S 1ST ST BLDG. 205
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City | TEMPLE
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State | TX
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Zip | 76504-7451
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Country | US
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Telephone | 254-743-2761
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Fax |
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Provider Business Mailing Address
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Address Line | 1901 S 1ST ST BLDG. 205
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City | TEMPLE
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State | TX
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Zip | 76504-7451
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Country | US
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Telephone |
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Fax |
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | K9467
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License Number State | TX
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