Provider Demographics
NPI:1407809874
Name:BAKER, JAMES R (DC)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:R
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 1:1053 S TRADE ST
Mailing Address - Street 2:
Mailing Address - City:TRYON
Mailing Address - State:NC
Mailing Address - Zip Code:28782-3790
Mailing Address - Country:US
Mailing Address - Phone:828-859-5055
Mailing Address - Fax:828-859-5042
Practice Address - Street 1:1053 S TRADE ST
Practice Address - Street 2:
Practice Address - City:TRYON
Practice Address - State:NC
Practice Address - Zip Code:28782-3790
Practice Address - Country:US
Practice Address - Phone:828-859-5055
Practice Address - Fax:828-859-5042
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-18
Last Update Date:2008-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2244111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC890821YMedicaid
NC890821YMedicaid
NC2450104BMedicare PIN