Individual
DR. MICHAEL LEO BAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
29 S FOURTH ST, ROLLING FORK, MS 39159-5146
(662) 873-4361
(662) 873-2921
Mailing address
702 MARTIN LUTHER KING ST, MOUND BAYOU, MS 38762-9314
(662) 741-8800
(662) 741-2700
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
15475
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0123141
—
MS
Enumeration date
07/14/2006
Last updated
07/24/2017
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