Provider Demographics
NPI:1053354274
Name:BAKER, PATRICK (DC)
Entity type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:
Last Name:BAKER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4781 RED BANK RD
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45227-1519
Mailing Address - Country:US
Mailing Address - Phone:513-561-2273
Mailing Address - Fax:513-561-5173
Practice Address - Street 1:675 DEIS DR
Practice Address - Street 2:STE A
Practice Address - City:FAIRFIELD
Practice Address - State:OH
Practice Address - Zip Code:45014-8136
Practice Address - Country:US
Practice Address - Phone:513-858-6700
Practice Address - Fax:513-561-3571
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2014-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2023111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
BA0759233Medicare PIN