Organization
EDMOND L BAKER JR MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EDMOND LOWE BAKER JR. MD (PRESIDENT)
(480) 280-7588
Entity
Organization
Contact information
Practice address
926 E MCDOWELL RD STE 134, PHOENIX, AZ 85006-2521
(602) 935-6270
(602) 899-1231
Mailing address
743 E WINDSONG DR, PHOENIX, AZ 85048-2069
(602) 935-6270
(602) 899-1231
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
—
—
261QF0050X
Non-Surgical Family Planning Clinic/Center
—
—
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
467843
—
AZ
Enumeration date
10/18/2018
Last updated
10/18/2018
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