WALLACE C BAKER NPI 1134140148

NPI Information

WALLACE C BAKER is a family medicine in Idaho Falls, ID. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. WALLACE C BAKER NPI is 1134140148. The provider is registered as an organization entity type and is a multiple single specialty group.
The provider Other Name Is Baker Family Practice.

The provider's business location address is:

1880 JOHN ADAMS PKWY
IDAHO FALLS, ID
ZIP 83401-315
Phone: (208) 524-6633
Fax: (208) 524-9952

The provider's authorized official is Wallace C. Baker .
The authorized official title is Doctor and has the following contact phone number (208) 524-6633.

The CLIA number assigned to this NPI record is 13D0927131 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 7/22/2006 and was last updated on 7/19/2010.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

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