MEDICARE: BRADLEY S BAKER MD PLLC

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	207X00000X	Orthopaedic Surgery Physician	40754	AZ

General Provider Information

NPI Number	:	1932364692
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BRADLEY S BAKER MD PLLC

Provider Business Mailing Address
First Line	:	1928 E HIGHLAND AVENUE
Second Line	:	F104-501
City	:	PHOENIX
State	:	AZ
Zip	:	85016-4636
Country	:	US
Telephone Number	:	602-324-0449
Fax Number	:	602-266-4477

Provider Business Practice Location Address
First Line	:	9327 N 3RD STREET
Second Line	:	STE. 200
City	:	PHOENIX
State	:	AZ
Zip	:	85020-2473
Country	:	US
Telephone Number	:	602-324-0449
Fax Number	:	602-266-4477

Authorized Official
Title or Position	:	OWNER/PHYSICIAN
Name	:	DR. BRADLEY S. BAKER
Credential	:	M.D.
Telephone Number	:	602-324-0449

Provider Enumeration Date	:	07/22/2008
Last Update Date	:	09/08/2008

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