Basic Information
| Provider Information | |||||||||
| NPI: | 1720325467 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BAKER | ||||||||
| FirstName: | DOUGLAS | ||||||||
| MiddleName: | HEDGE | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | II | ||||||||
| Credential: | CRNA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 437 S MILLER DR | ||||||||
| Address2: | |||||||||
| City: | SUNBURY | ||||||||
| State: | OH | ||||||||
| PostalCode: | 430748472 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3307051448 | ||||||||
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| Practice Location | |||||||||
| Address1: | 100 W NORTH ST | ||||||||
| Address2: | |||||||||
| City: | SPRINGFIELD | ||||||||
| State: | OH | ||||||||
| PostalCode: | 455042547 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9375231000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 01/15/2013 | ||||||||
| LastUpdateDate: | 01/15/2013 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 367500000X | COA.14168 | OH | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered |
No ID Information.