Individual
MR. DEREK LADON BAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
61 WHITCHER ST NE STE 3110, MARIETTA, GA 30060
(770) 422-2326
Mailing address
805 SANDY PLAINS ROAD, MEDICAL STAFF SERVICES, MARIETTA, GA 30066-6340
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
006567
GA
Other
Enumeration date
10/05/2012
Last updated
11/06/2019
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