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Individual

DR. JACK ROSS BAKER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
4590 DRESSLER ROAD NW, CANTON, OH 44718-2546
(330) 492-5555
(330) 492-7808
Mailing address
4590 DRESSLER ROAD NW, CANTON, OH 44718-2546
(330) 492-5555
(330) 492-7808

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
34003239B
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0672884
OH
Enumeration date
08/29/2006
Last updated
04/09/2010
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