Individual
DR. JACK R BAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
210 25TH AVE N STE 1204, NASHVILLE, TN 37203-1620
(615) 312-0600
(615) 320-3259
Mailing address
210 25TH AVE N STE 1204, NASHVILLE, TN 37203-1620
(615) 312-0600
(615) 320-3259
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
18615
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1509034
—
TN
01
—
300116569
RR MEDICARE
—
05
—
3051603
—
TN
05
—
3051608
—
TN
01
—
3159114
BLUE CROSS BLUE SHIELD TN
TN
05
—
3718587
—
TN
01
—
3721492
RA GROUP
TN
05
—
64037765
—
KY
Enumeration date
12/22/2005
Last updated
03/03/2021
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