Individual
LARRY J BAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1200 PLEASANT ST, S-128, DES MOINES, IA 50309
(515) 241-6076
Mailing address
13909 OAK BROOK DR, URBANDALE, IA 50323-2134
(515) 987-2574
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
1721
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1154781
—
IA
05
—
2154781
—
IA
01
—
930039470
RAILROAD MEDICARE
IA
Enumeration date
11/10/2006
Last updated
08/19/2013
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