Provider Demographics
NPI:1164626289
Name:BAKER, JESSICA T (DO)
Entity Type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:T
Last Name:BAKER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:3237 BRISTOL RD STE 203
Mailing Address - Street 2:
Mailing Address - City:BENSALEM
Mailing Address - State:PA
Mailing Address - Zip Code:19020-2172
Mailing Address - Country:US
Mailing Address - Phone:215-559-9166
Mailing Address - Fax:215-910-4584
Practice Address - Street 1:3237 BRISTOL RD STE 203
Practice Address - Street 2:
Practice Address - City:BENSALEM
Practice Address - State:PA
Practice Address - Zip Code:19020-2172
Practice Address - Country:US
Practice Address - Phone:215-559-9166
Practice Address - Fax:215-910-4584
Is Sole Proprietor?:No
Enumeration Date:2007-06-13
Last Update Date:2024-02-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAOS013525207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine