Provider Demographics
NPI:1801866199
Name:BAITES,, JOHN E JR (MD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:E
Last Name:BAITES,
Suffix:JR
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:PO BOX 710
Mailing Address - Street 2:
Mailing Address - City:GOODLETTSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37070-0710
Mailing Address - Country:US
Mailing Address - Phone:615-859-1440
Mailing Address - Fax:615-859-0145
Practice Address - Street 1:450 PROFESSIONAL PARK DR
Practice Address - Street 2:
Practice Address - City:GOODLETTSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37072-2180
Practice Address - Country:US
Practice Address - Phone:615-859-1440
Practice Address - Fax:615-859-0145
Is Sole Proprietor?:No
Enumeration Date:2006-01-26
Last Update Date:2025-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD13994207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3195131Medicaid
TN3195131Medicaid
3195131Medicare ID - Type Unspecified