Organization
GLEN RAY BAKER JR P S C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GLEN RAY BAKER JR. M.D. (PRESIDENT)
(606) 523-1553
Entity
Organization
Contact information
Practice address
1007 CUMBERLAND FALLS HWY, CORBIN, KY 40701-2714
(606) 523-1553
Mailing address
1200 RAVENWOOD DR, CORBIN, KY 40701-2172
(606) 523-1553
(606) 523-1593
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
15090
KY
Other
Enumeration date
04/02/2008
Last updated
06/18/2008
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