Provider Demographics
NPI:1992753271
Name:BAKER, PAUL L (MD)
Entity type:Individual
Prefix:DR
First Name:PAUL
Middle Name:L
Last Name:BAKER
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1241 W MINERAL AVE
Mailing Address - Street 2:SUITE100
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80120-5685
Mailing Address - Country:US
Mailing Address - Phone:303-759-0854
Mailing Address - Fax:303-759-0864
Practice Address - Street 1:2222 N NEVADA AVE
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80907-6831
Practice Address - Country:US
Practice Address - Phone:719-776-3216
Practice Address - Fax:719-776-3187
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-05
Last Update Date:2010-03-23
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Provider Licenses
StateLicense IDTaxonomies
CO38500207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO81358229Medicaid
CO930128896OtherRR MEDICARE
COF97937Medicare UPIN
CO930128896OtherRR MEDICARE