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NPI Code Detail

MEDICARE: KIMBERLY BAKER M.D.

MEDICARE: KIMBERLY BAKER M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician2022013209MO

General Provider Information

NPI Number : 1043693104
Entity Type Code : Individual
Provider Name (Legal Business Name) : KIMBERLY BAKER M.D.
Provider Business Mailing Address
First Line : 27TH MEDICAL GROUP/SGHC
Second Line : 224 W D.L. INGRAM AVE
City : CANNON AFB
State : NM
Zip : 88103-5103
Country : US
Telephone Number : 575-904-3917
Fax Number : 575-784-6028
Provider Business Practice Location Address
First Line : 3202 MILLER ST
Second Line :
City : BETHANY
State : MO
Zip : 64424-2713
Country : US
Telephone Number : 660-425-3154
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/07/2015
Last Update Date : 06/24/2026

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Directions to “ KIMBERLY BAKER M.D.” Practice Location

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