Individual
AUSTIN BAKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
3200 CHANNING WAY STE A105, IDAHO FALLS, ID 83404-7561
(208) 552-9530
Mailing address
715 CASTLEROCK LN, IDAHO FALLS, ID 83404-7997
(208) 709-7082
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
2019023472
MO
Other
Enumeration date
06/27/2019
Last updated
08/20/2024
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