Individual
KEITH ANDREW BAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
559 VINCENT ST, 21 MDOS/SGOF -FAM HLTH, PETERSON AFB, CO 80914-1540
(719) 556-2273
(719) 556-1226
Mailing address
110 W. ENT AVE., 21 MDOS/SGOF -FAMILY PRACTICE, PETERSON AFB, CO 80914-1540
(719) 556-2273
(719) 566-1226
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
26315
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01263151
—
CO
Enumeration date
06/01/2005
Last updated
09/24/2014
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