Individual
DR. THOMAS ROBERT BAEKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
520 TECHWOOD DRIVE, SUITE 100, DANVILLE, KY 40422-8500
(859) 236-2203
(859) 238-2206
Mailing address
520 TECHWOOD DRIVE, SUITE 100, DANVILLE, KY 40422-8500
(859) 936-9844
(859) 238-2206
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
207RH0003X
KY
207RH0003X
Hematology & Oncology Physician
Primary
28455
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00000051069
ANTHEM BC/BS
KY
01
—
023379600
FEDERAL BLACK LUNG
KY
01
—
1066562
PASSPORT
KY
01
—
110109119
RAILROAD MEDICARE
KY
01
—
4242445
AETNA
KY
01
—
611277847
CHA
KY
05
—
64284557
—
KY
01
—
87107
COVENTRYCARES OF KENTUCKY
KY
01
—
A13422
BLUEGRASS FAMILY HEALTH
KY
Enumeration date
06/16/2005
Last updated
11/04/2011
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