Basic Information
| Provider Information | |||||||||
| NPI: | 1285048363 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BAKER | ||||||||
| FirstName: | REECE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 933 E 1910 S | ||||||||
| Address2: | |||||||||
| City: | PROVO | ||||||||
| State: | UT | ||||||||
| PostalCode: | 846065561 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8013624119 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1134 N 500 W | ||||||||
| Address2: | |||||||||
| City: | PROVO | ||||||||
| State: | UT | ||||||||
| PostalCode: | 846043383 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8013577850 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/17/2014 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | 4301105214 | MI | N | Allopathic & Osteopathic Physicians | Emergency Medicine | 207P00000X | 10167220-1205 | UT | Y | Allopathic & Osteopathic Physicians | Emergency Medicine |
No ID Information.