George Clifford Baacke II, MD
Individual provider Active NPI Family Medicine Physician · Shiprock, NM
NPI 1366432775 · NPPES record last updated May 3, 2019
Key facts
- NPI
- 1366432775
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 026500E (PA)
- Practice address
- US Hwy 491 North
Shiprock, NM 87420 - Phone
- (505) 368-6001
- Fax
- (505) 368-7011
- NPI assigned
- Oct 26, 2005
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 026500E | PA | MD | Family Medicine Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 026500E | PA | Yes |
Addresses
Primary practice location
US Hwy 491 North
Shiprock, NM 87420
Mailing address
PO Box 160
Shiprock, NM 87420-0160
Phone (505) 368-6001
Other providers in Shiprock, NM
- Hope Arhelger
- Kerrianne Ashley
- Danielle R Atencio-Archibeque
- Joanna N Atencio
- Asha E Atwell
- Karen Marie Bachman-Carter
- Joshua Bacon
- Hillary Baker
- Michael C Barish
- Denise Suzanne Bartley
All providers in Shiprock, NM · Family Medicine Physician in New Mexico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 3, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.