Provider Demographics
NPI:1679547848
Name:BAKER, MURRAY LESTER (MD)
Entity type:Individual
Prefix:
First Name:MURRAY
Middle Name:LESTER
Last Name:BAKER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 6907
Mailing Address - Street 2:
Mailing Address - City:DOTHAN
Mailing Address - State:AL
Mailing Address - Zip Code:36302
Mailing Address - Country:US
Mailing Address - Phone:334-793-5000
Mailing Address - Fax:334-615-8419
Practice Address - Street 1:4370 W MAIN ST
Practice Address - Street 2:
Practice Address - City:DOTHAN
Practice Address - State:AL
Practice Address - Zip Code:36305
Practice Address - Country:US
Practice Address - Phone:334-793-5000
Practice Address - Fax:334-615-8419
Is Sole Proprietor?:No
Enumeration Date:2006-02-15
Last Update Date:2009-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL17920207P00000X
FL046835207Q00000X
FLME46835207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00337367CMedicaid
MS08375878Medicaid
LA1736171Medicaid
FL261019100Medicaid
AL51515769OtherBLUE CROSS BLUE SHIELD
AL051515769Medicaid
FL274144000Medicaid
P00055567OtherRAILROAD MEDICARE
AL051515769Medicaid
LA1736171Medicaid