Provider Demographics
NPI:1033202288
Name:BAKER, WILLIAM T (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:T
Last Name:BAKER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4601 ABERCORNE TER
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40241-6145
Mailing Address - Country:US
Mailing Address - Phone:502-897-3241
Mailing Address - Fax:502-969-3799
Practice Address - Street 1:200 E CHESTNUT ST DEPT 3R
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40202-1831
Practice Address - Country:US
Practice Address - Phone:502-629-7181
Practice Address - Fax:502-629-6957
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2013-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY21175207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100004200Medicaid
KY50022679OtherPASSPORT - WS
KY000023035ROtherHUMANA - WS
KY103689OtherSIHO - WS
KY00533116OtherMEDICARE KY - WS
KY1069145OtherPASSPORT
KY3698416000OtherPASSPORT ADVTG - WS
KY64211758Medicaid
KY1033202288OtherRAILROAD MEDICARE
KY000000605980OtherANTHEM - WS
KY2537857OtherCIGNA - WS
KY50022679OtherPASSPORT - WS
KY1033202288Medicare PIN