Organization
JACK R. BAKER, D.O., INC.
Active
Other names
JACK R. BAKER, D.O., INC.
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JACK ROSS BAKER D.O. (PRESIDENT)
(330) 493-5555
Entity
Organization
Contact information
Practice address
4590 DRESSLER RD NW, CANTON, OH 44718-2546
(330) 492-5555
(330) 492-7808
Mailing address
4590 DRESSLER RD NW, CANTON, OH 44718-2546
(330) 492-5555
(330) 492-7808
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
34-00-3232B
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0672884
—
OH
Enumeration date
08/23/2007
Last updated
08/23/2007
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