Provider Demographics
NPI:1922086693
Name:BAKER, JOSEPH M (DO)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:M
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 1:3521 NE RALPH POWELL RD
Mailing Address - Street 2:
Mailing Address - City:LEES SUMMIT
Mailing Address - State:MO
Mailing Address - Zip Code:64064-2337
Mailing Address - Country:US
Mailing Address - Phone:816-554-8346
Mailing Address - Fax:816-554-9470
Practice Address - Street 1:3521 NE RALPH POWELL RD
Practice Address - Street 2:
Practice Address - City:LEES SUMMIT
Practice Address - State:MO
Practice Address - Zip Code:64064-2337
Practice Address - Country:US
Practice Address - Phone:816-554-8346
Practice Address - Fax:816-554-9470
Is Sole Proprietor?:No
Enumeration Date:2006-01-04
Last Update Date:2023-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS0519455202K00000X
KS05-19455207Q00000X
MO2023014079207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No202K00000XAllopathic & Osteopathic PhysiciansPhlebology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KST80105Medicare UPIN