Provider Demographics
NPI:1356324586
Name:BAKER, TIMOTHY DARRELL (MD)
Entity Type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:DARRELL
Last Name:BAKER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2006 FRANKLIN ST SE STE 200
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35801-4537
Mailing Address - Country:US
Mailing Address - Phone:256-539-0457
Mailing Address - Fax:256-539-5827
Practice Address - Street 1:2006 FRANKLIN ST SE STE 200
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-4537
Practice Address - Country:US
Practice Address - Phone:256-539-0457
Practice Address - Fax:256-539-5827
Is Sole Proprietor?:No
Enumeration Date:2005-11-22
Last Update Date:2023-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN551382085R0202X
MS170772085R0202X
ARE-35162085R0202X
AL259632085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL009963725Medicaid
11452753OtherCAQH
51531050OtherBCBS OF ALABAMA
AL51595562OtherBCBS
AL245854Medicaid
AL51595561OtherBCBS
AL51595569OtherBCBS
AL51595570OtherBCBS
AL245674Medicaid
AL51067225OtherBCBS
AL51595560OtherBCBS
AL051554821Medicaid
AL135573Medicaid
AL213229Medicaid
AL245699Medicaid
AL009963705Medicaid
AL009963735Medicaid
AL243911Medicaid
AL244308Medicaid
AL51523305OtherBCBS OF AL
AL51545455OtherBCBS-ONC. SPECIALTIES
AL009911016Medicaid
AL266496Medicaid
AL009942790Medicaid
AL126883Medicaid
AL51595563OtherBCBS