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Individual

CHARLES BAKER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PHYSICIAN ASSISTANCE

Contact information

Practice address
334 SMITH AVE, THOMASVILLE, GA 31792-5533
(229) 227-1595
(229) 227-1385
Mailing address
334 SMITH AVE, THOMASVILLE, GA 31792-5533
(229) 227-1595
(229) 227-1385

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
003660
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100001820P
GA
Enumeration date
06/15/2006
Last updated
09/13/2018
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