MEDICARE: DR. TIMOTHY DARRELL 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
1	2085R0202X	Diagnostic Radiology Physician	55138	TN
2	2085R0202X	Diagnostic Radiology Physician	17077	MS
3	2085R0202X	Diagnostic Radiology Physician	E-3516	AR
4	2085R0202X	Diagnostic Radiology Physician	25963	AL

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	11452753	OTHER		CAQH
3	51531050	OTHER		BCBS OF ALABAMA
4	51595562	OTHER	AL	BCBS
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	51595561	OTHER	AL	BCBS
7	51595569	OTHER	AL	BCBS
8	51595570	OTHER	AL	BCBS
9	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
10	51067225	OTHER	AL	BCBS
11	51595560	OTHER	AL	BCBS
12	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
13	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
14	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
15	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
16	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
17	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
18	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
19	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
20	51523305	OTHER	AL	BCBS OF AL
21	51545455	OTHER	AL	BCBS-ONC. SPECIALTIES
22	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
23	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
24	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
25	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
26	51595563	OTHER	AL	BCBS

General Provider Information

NPI Number	:	1356324586
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TIMOTHY DARRELL BAKER M.D.

Provider Business Mailing Address
First Line	:	2006 FRANKLIN ST SE STE 200
Second Line	:
City	:	HUNTSVILLE
State	:	AL
Zip	:	35801-4537
Country	:	US
Telephone Number	:	256-539-0457
Fax Number	:	256-539-5827

Provider Business Practice Location Address
First Line	:	2006 FRANKLIN ST SE STE 200
Second Line	:
City	:	HUNTSVILLE
State	:	AL
Zip	:	35801-4537
Country	:	US
Telephone Number	:	256-539-0457
Fax Number	:	256-539-5827

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

Provider Enumeration Date	:	11/22/2005
Last Update Date	:	08/10/2023

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