Individual
DR. TERRY BAKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3200 CHANNING WAY, A-105, IDAHO FALLS, ID 83404-7546
(208) 552-9530
(208) 522-6262
Mailing address
3200 CHANNING WAY, A-105, IDAHO FALLS, ID 83404-7546
(208) 552-9530
(208) 522-6262
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
M8221
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
805984700
—
ID
Enumeration date
06/15/2006
Last updated
09/06/2007
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