Provider Demographics
NPI:1275510885
Name:BAKER, ROBERT K (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:K
Last Name:BAKER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:932 SPRING CREEK RD
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37412-3910
Mailing Address - Country:US
Mailing Address - Phone:423-894-1453
Mailing Address - Fax:423-899-8022
Practice Address - Street 1:932 SPRING CREEK RD
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37412-3910
Practice Address - Country:US
Practice Address - Phone:423-894-1453
Practice Address - Fax:423-899-8022
Is Sole Proprietor?:No
Enumeration Date:2005-12-23
Last Update Date:2007-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT042-0010602207W00000X
NY228400-1207W00000X
TN41220207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNP00321873OtherRAILROAD MEDICARE
VT1009739Medicaid
TN3814608Medicaid
TN4125520OtherBCBSTN
NY02405498Medicaid
TN4125520OtherBCBSTN
H83821Medicare UPIN
VT1009739Medicaid
VTVN3180Medicare PIN