Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | 46667 | GA |
N | 207PE0004X | Emergency Medical Services | DO 724 | AL |
NPI | 1003873860 |
---|---|
Provider Name | Donald V Baker |
First Address | Pell City, AL 35125-5114 |
Second Address | Pell City, AL 35125-5114 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/04/2006 |
Last Update Date | 04/03/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
009961170 | (05) | AL |
G87803 | (02) | AL |