Provider Demographics
NPI:1225006794
Name:BAKER, JOHN E (DPM)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:E
Last Name:BAKER
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:6317 SEALAWN DR
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:FL
Mailing Address - Zip Code:34607-2638
Mailing Address - Country:US
Mailing Address - Phone:352-597-2223
Mailing Address - Fax:352-597-2061
Practice Address - Street 1:6317 SEALAWN DR
Practice Address - Street 2:
Practice Address - City:SPRING HILL
Practice Address - State:FL
Practice Address - Zip Code:34607-2638
Practice Address - Country:US
Practice Address - Phone:352-597-2223
Practice Address - Fax:352-597-2061
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-10
Last Update Date:2013-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO2324213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL390105000Medicaid
FL480025634OtherMEDICARE RAILROAD
FL4678980001Medicare NSC
FL65288Medicare PIN
FLU42140Medicare UPIN