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General NPI Number Information
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NPI Number | 1386249233
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Entity Type | Individual
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Provider Name | DAVID J BAKER PHARM D
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Gender | Male
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Dates
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Enumeration Date | 11/30/2020
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Last Update Date | 11/30/2020
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Provider Practice Location Address
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Address Line | 735 W STADIUM BLVD
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City | JEFFERSON CITY
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State | MO
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Zip | 65109-4753
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Country | US
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Telephone | 573-893-1079
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Fax |
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Provider Business Mailing Address
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Address Line | 424 BRADFORD LN
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City | LOOSE CREEK
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State | MO
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Zip | 65054-2710
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Country | US
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Telephone | 573-694-7390
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 2013024751
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License Number State | MO
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