| Doctor Name: | MR. SCOTT MATTHEW BAKER |
| NPI Number: | 1114941929 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | F.N.P. |
| License Number: | 209-003513 |
| Business Practice Address: | 1381 South Patrick Drive Patrick Afb, FL - 32925 |
| Business Phone Number: | 3214948241 |
| Business Fax Number: | 3214948002 |
| Mailing Address: | 1381 South Patrick Drive, PATRICK AFB |
| State: | FL |
| Postal Code: | 32925 |
| Phone Number: | 3214948241 |
| Fax Number: | 3214948002 |
| NPI Enumeration Date: | 07/26/2006 |
| NPI Last Update Date: | 02/01/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 209-003513 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |