Provider Demographics
NPI:1174683833
Name:BAKER, DAVID C (DC)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:C
Last Name:BAKER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3611 CENTRAL AVE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:COLUMBUS
Mailing Address - State:IN
Mailing Address - Zip Code:47203-6000
Mailing Address - Country:US
Mailing Address - Phone:812-372-2537
Mailing Address - Fax:812-372-2537
Practice Address - Street 1:3611 CENTRAL AVE
Practice Address - Street 2:SUITE 300
Practice Address - City:COLUMBUS
Practice Address - State:IN
Practice Address - Zip Code:47203-6000
Practice Address - Country:US
Practice Address - Phone:812-372-2537
Practice Address - Fax:812-372-2537
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-11
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN08001858111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN151330Medicare ID - Type UnspecifiedMEDICARE
INT97143Medicare UPIN