Provider Demographics
NPI:1053901355
Name:BAKER, SCOTT (PHARMD)
Entity type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:
Last Name:BAKER
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:186 MEDICAL DR
Mailing Address - Street 2:
Mailing Address - City:WINFIELD
Mailing Address - State:AL
Mailing Address - Zip Code:35594-5002
Mailing Address - Country:US
Mailing Address - Phone:205-487-3079
Mailing Address - Fax:205-487-3138
Practice Address - Street 1:186 MEDICAL DR
Practice Address - Street 2:
Practice Address - City:WINFIELD
Practice Address - State:AL
Practice Address - Zip Code:35594-5002
Practice Address - Country:US
Practice Address - Phone:205-487-3079
Practice Address - Fax:205-487-3138
Is Sole Proprietor?:No
Enumeration Date:2021-01-20
Last Update Date:2021-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL12850183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist