Individual
DR. CLARK D BAKER III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2805 DR JOHN HAYNES DR, PELL CITY, AL 35125-1448
(205) 814-2104
(205) 814-2145
Mailing address
PO BOX 11407, LOCKBOX 1061, BIRMINGHAM, AL 35246-1061
(205) 437-6098
(205) 437-5998
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
21072
AL
207R00000X
Internal Medicine Physician
21072
AL
207RC0000X
Cardiovascular Disease Physician
Primary
21072
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
051522553
BCBS
AL
05
—
051522553
—
AL
01
—
051540582
BCBS
AL
Enumeration date
09/21/2005
Last updated
11/18/2008
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