Basic Information
| Provider Information | |||||||||
| NPI: | 1659330827 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BAKER | ||||||||
| FirstName: | THOMAS | ||||||||
| MiddleName: | EDWIN | ||||||||
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| Credential: | DO | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5131 BEACON HILL RD | ||||||||
| Address2: | SUITE 160 | ||||||||
| City: | COLUMBUS | ||||||||
| State: | OH | ||||||||
| PostalCode: | 432284442 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6145442815 | ||||||||
| FaxNumber: | 6145442816 | ||||||||
| Practice Location | |||||||||
| Address1: | 5131 BEACON HILL RD | ||||||||
| Address2: | SUITE 160 | ||||||||
| City: | COLUMBUS | ||||||||
| State: | OH | ||||||||
| PostalCode: | 432284442 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6145442815 | ||||||||
| FaxNumber: | 6145442816 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/17/2006 | ||||||||
| LastUpdateDate: | 02/09/2013 | ||||||||
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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 | 207X00000X | 34002355 | OH | Y | Allopathic & Osteopathic Physicians | Orthopaedic Surgery |
ID Information
| ID | Type | State | Issuer | Description | 0004202190 | 01 | AETNA | OTHER | 0900910 | 01 | UNITED HEALTHCARE | OTHER | 200023306 | 01 | RAILROAD MEDICARE | OTHER | 8960 | 01 | OHIO HEALTH CHOICE | OTHER | 0900007 | 01 | UNITED HEALTHCARE | OTHER | 310846816THB | 01 | SUMMIT | OTHER | 64786676 | 05 | KY | MEDICAID | 8960 | 01 | NATIONWIDE | OTHER | 000000006750 | 01 | ANTHEM | OTHER | 1777531 | 01 | CIGNA | OTHER | 000000006749 | 01 | ANTHEM | OTHER | 310846816005 | 01 | PRUDENTIAL | OTHER | 990006985 | 01 | RAILROAD MEDICARE | OTHER |