Provider Demographics
NPI:1659330827
Name:BAKER, THOMAS EDWIN (DO)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:EDWIN
Last Name:BAKER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5131 BEACON HILL RD
Mailing Address - Street 2:SUITE 160
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43228-4442
Mailing Address - Country:US
Mailing Address - Phone:614-544-2815
Mailing Address - Fax:614-544-2816
Practice Address - Street 1:5131 BEACON HILL RD
Practice Address - Street 2:SUITE 160
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43228-4442
Practice Address - Country:US
Practice Address - Phone:614-544-2815
Practice Address - Fax:614-544-2816
Is Sole Proprietor?:No
Enumeration Date:2006-03-17
Last Update Date:2013-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34002355207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
0004202190OtherAETNA
0900910OtherUNITED HEALTHCARE
200023306OtherRAILROAD MEDICARE
8960OtherOHIO HEALTH CHOICE
0900007OtherUNITED HEALTHCARE
310846816THBOtherSUMMIT
KY64786676Medicaid
8960OtherNATIONWIDE
000000006750OtherANTHEM
1777531OtherCIGNA
000000006749OtherANTHEM
310846816005OtherPRUDENTIAL
990006985OtherRAILROAD MEDICARE
KY64786676Medicaid