DoctorDataHub
Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

WALLACE C BAKER, M.D.

Active Sole Proprietor

Family Medicine · IDAHO FALLS, ID

Registration Details

NPI Number
1083696967
Provider Type
Individual
Gender
Male
NPI Issued
Nov 16, 2005 (20.428753361955 yrs)
Last Updated
Jul 19, 2010
License
M2619 (ID)
Sole Proprietor
Yes

Practice Information

Address
1880 JOHN ADAMS PKWY
IDAHO FALLS, ID, 834014315
Browse ID providers · Browse ZIP 83401
Phone
2085246633
Fax
2085249952
Primary Specialty
Family Medicine
207Q00000X

Other Family Medicine Providers in IDAHO FALLS, ID

Name Credential NPI
DR. ERIC W. PERTTULA M.D. 1710988894
DR. LARAMIE L. WHEELER D.O. 1801889456
DR. JULIAN DE BRUYN KOPS III MD 1922086552
JUDY LEE JONES MD 1295707099
BRAD C ERIKSON DO 1164477931
MRS. REBECCA H ADAMS MD 1689610842
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.