Provider Demographics
NPI:1376944496
Name:BAKER, JAY SCOTT (MD)
Entity Type:Individual
Prefix:
First Name:JAY
Middle Name:SCOTT
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 1:8 FOXCLIFF CT
Mailing Address - Street 2:
Mailing Address - City:BALLWIN
Mailing Address - State:MO
Mailing Address - Zip Code:63011-4233
Mailing Address - Country:US
Mailing Address - Phone:636-394-9353
Mailing Address - Fax:636-394-9353
Practice Address - Street 1:8 FOXCLIFF CT
Practice Address - Street 2:
Practice Address - City:BALLWIN
Practice Address - State:MO
Practice Address - Zip Code:63011-4233
Practice Address - Country:US
Practice Address - Phone:636-394-9353
Practice Address - Fax:636-394-9353
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-08
Last Update Date:2014-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOR4541207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine