MEDICARE: ROBERT LEE BAKER MD

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
1	207Q00000X	Family Medicine Physician	23506	KY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1205896503
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERT LEE BAKER MD

Provider Business Mailing Address
First Line	:	PO BOX 635283
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45263-5283
Country	:	US
Telephone Number	:	859-341-3114
Fax Number	:	859-578-2156

Provider Business Practice Location Address
First Line	:	2300 CHAMBER CENTER DR
Second Line	:	SUITE 100
City	:	FORT MITCHELL
State	:	KY
Zip	:	41017
Country	:	US
Telephone Number	:	859-341-3114
Fax Number	:	859-578-2156

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/23/2006
Last Update Date	:	09/07/2018

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