Provider Demographics
NPI:1073557484
Name:BAKER, LARRY DEAN (EDD)
Entity Type:Individual
Prefix:DR
First Name:LARRY
Middle Name:DEAN
Last Name:BAKER
Suffix:
Gender:M
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 133
Mailing Address - Street 2:
Mailing Address - City:MURPHY
Mailing Address - State:NC
Mailing Address - Zip Code:28906-0133
Mailing Address - Country:US
Mailing Address - Phone:828-835-7002
Mailing Address - Fax:828-835-7011
Practice Address - Street 1:3756 US HWY 64 E ALTERNATE
Practice Address - Street 2:SUITE 10
Practice Address - City:MURPHY
Practice Address - State:NC
Practice Address - Zip Code:28906-6802
Practice Address - Country:US
Practice Address - Phone:828-835-7002
Practice Address - Fax:828-835-7011
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-15
Last Update Date:2012-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246Z00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, Other
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2881835Medicare PIN