Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2081P2900X | Pain Medicine | MD0003132 | TN |
NPI | 1104837327 |
---|---|
Provider Name | Thomas Scott Baker |
First Address | Lebanon, TN 37088-1165 |
Second Address | Lebanon, TN 37087-3061 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/08/2006 |
Last Update Date | 18/01/2017 |