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NPI Code Detail

MEDICARE: JOEL LEN BAKER DO

MEDICARE: JOEL LEN BAKER DO
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 Physician02857IA
2207QA0505XAdult Medicine Physician02857IA

Other Identifiers

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

General Provider Information

NPI Number : 1518943141
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOEL LEN BAKER DO
Provider Business Mailing Address
First Line : P.O. BOX 365
Second Line :
City : CORYDON
State : IA
Zip : 50060-0365
Country : US
Telephone Number : 641-932-7172
Fax Number : 641-932-7174
Provider Business Practice Location Address
First Line : 417 S. EAST
Second Line :
City : CORYDON
State : IA
Zip : 50060-1860
Country : US
Telephone Number : 641-872-2063
Fax Number : 641-872-2070
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/15/2005
Last Update Date : 01/08/2019

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