Provider Demographics
NPI:1912525916
Name:DOCTOR JORDANNA BAKER
Entity Type:Organization
Organization Name:DOCTOR JORDANNA BAKER
Other - Org Name:BEST FOOT FORWARD SURGICAL PODIATRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:JORDAN
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:BAKER
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:843-286-5150
Mailing Address - Street 1:218 DOZIER BLVD STE B
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29501-4075
Mailing Address - Country:US
Mailing Address - Phone:843-286-5150
Mailing Address - Fax:843-919-0560
Practice Address - Street 1:218 DOZIER BLVD STE B
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:SC
Practice Address - Zip Code:29501-4075
Practice Address - Country:US
Practice Address - Phone:843-286-5150
Practice Address - Fax:843-919-0560
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-07
Last Update Date:2021-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QP1100XAmbulatory Health Care FacilitiesClinic/CenterPodiatric
No213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC610OtherLLR