Individual
JEFFREY THAYNE BAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2000 N. BOISE AVE., LOVELAND, CO 80538-7282
(970) 635-4071
(303) 306-7753
Mailing address
P.O. BOX 173817, DENVER, CO 80217-8643
(303) 306-7783
(303) 306-7753
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
35303
CO
207P00000X
Emergency Medicine Physician
Primary
DR.0035303
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
33583579
—
CO
01
—
930114618
RAILROAD MEDICARE
CO
01
—
P5808
BCBS
CO
Enumeration date
07/10/2006
Last updated
08/25/2015
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