Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Y00000X | Otolaryngologist (ENT Doctor) | DR.0056654 | CO |
Y | 207YX0007X | Plastic Surgeon (Head & Neck) | DR.0056654 | CO |
NPI | 1891010674 |
---|---|
Provider Name | Dr. Adam Lee Baker |
First Address | Grand Junction, CO 81502-1727 |
Second Address | Grand Jct, CO 81505-1006 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/04/2010 |
Last Update Date | 13/05/2020 |