Provider Demographics
NPI:1639305485
Name:BAKER FAMILY MEDICINE LLC
Entity Type:Organization
Organization Name:BAKER FAMILY MEDICINE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:JON
Authorized Official - Middle Name:H
Authorized Official - Last Name:BAKER
Authorized Official - Suffix:JR
Authorized Official - Credentials:DO
Authorized Official - Phone:513-737-6068
Mailing Address - Street 1:2449 ROSS MILLVILLE RD
Mailing Address - Street 2:SUITE B50
Mailing Address - City:HAMILTON
Mailing Address - State:OH
Mailing Address - Zip Code:45013-8951
Mailing Address - Country:US
Mailing Address - Phone:513-737-6068
Mailing Address - Fax:513-737-6681
Practice Address - Street 1:2449 ROSS MILLVILLE RD
Practice Address - Street 2:SUITE B50
Practice Address - City:HAMILTON
Practice Address - State:OH
Practice Address - Zip Code:45013-8951
Practice Address - Country:US
Practice Address - Phone:513-737-6068
Practice Address - Fax:513-737-6681
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-08
Last Update Date:2009-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty