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Individual

SHANNON COOKE BAKER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
2655 W 9000 S, WEST JORDAN, UT 84088-8542
(801) 256-6343
(801) 256-6344
Mailing address
PO BOX 27128, SALT LAKE CITY, UT 84127-0128
(801) 256-6343
(801) 256-6344

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
5691300-1205
UT
207Q00000X
Family Medicine Physician
M7024
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
187932201
TX
05
187932202
TX
05
942854058645
UT
01
P00662743
RAILROAD MEDICARE
TX
Enumeration date
12/05/2006
Last updated
04/14/2026
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