Individual
DR. JACK R BAKER
Active
Individual
DR. JACK R BAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
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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