Provider Demographics
NPI:1003873860
Name:BAKER, DONALD V (DO FACEP)
Entity Type:Individual
Prefix:
First Name:DONALD
Middle Name:V
Last Name:BAKER
Suffix:
Gender:M
Credentials:DO FACEP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7063 VETERANS PKWY
Mailing Address - Street 2:
Mailing Address - City:PELL CITY
Mailing Address - State:AL
Mailing Address - Zip Code:35125-5114
Mailing Address - Country:US
Mailing Address - Phone:205-814-2105
Mailing Address - Fax:205-814-2105
Practice Address - Street 1:7063 VETERANS PKWY
Practice Address - Street 2:
Practice Address - City:PELL CITY
Practice Address - State:AL
Practice Address - Zip Code:35125-5114
Practice Address - Country:US
Practice Address - Phone:205-814-2105
Practice Address - Fax:205-814-2105
Is Sole Proprietor?:No
Enumeration Date:2006-04-27
Last Update Date:2020-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALDO 724207PE0004X
GA46667207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL009961170Medicaid
AL051551282Medicare ID - Type Unspecified
ALG87803Medicare UPIN