Michael L Baker DO PA

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

15475 Issued in MS

Legal business name

MICHAEL L BAKER DO PA

Practice address

129 S Main St
Yazoo City, MS 39194-4007

Phone

(662) 746-8777

NPI assigned

Mar 18, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Michael Leo Baker, D.O.

Title

President and Ceo

Phone

(662) 746-8777

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1205798400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1226448000000",
    "number": "1568633543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "129 S. MAIN STREET",
            "city": "YAZOO CITY",
            "state": "MS",
            "postal_code": "39194",
            "telephone_number": "662-746-8777",
            "fax_number": "662-746-8778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "129 S MAIN ST",
            "city": "YAZOO CITY",
            "state": "MS",
            "postal_code": "391944007",
            "telephone_number": "662-746-8777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL L BAKER DO PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-18",
        "last_updated": "2008-11-12",
        "status": "A",
        "authorized_official_last_name": "BAKER",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "LEO",
        "authorized_official_title_or_position": "PRESIDENT AND CEO",
        "authorized_official_telephone_number": "662-746-8777",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "MS",
            "license": "15475",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09016054",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Mississippi State Department of Health
• Amber Moore
• Milya Moore

• Family Medicine Physician in Yazoo City, MS
• Providers in Yazoo City, MS by specialty
• Family Medicine Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.