Individual
DR. KENNETH JOHN BAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
16000 JOHNSTON MEMORIAL DR STE 200, ABINGDON, VA 24211-7664
(276) 628-4335
Mailing address
1021 W OAKLAND AVE STE 310, JOHNSON CITY, TN 37604-2192
(423) 302-6565
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
0101274657
VA
207V00000X
Obstetrics & Gynecology Physician
28597
WV
207V00000X
Obstetrics & Gynecology Physician
28822
SC
207V00000X
Obstetrics & Gynecology Physician
39390
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
28822
SC LICENSE
SC
01
—
39390
NC LICENSE
NC
05
—
N39390
—
SC
01
—
SC34823365
MEDICARE PIN
SC
Enumeration date
04/10/2006
Last updated
07/17/2024
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