MEDICARE: DR. JOSHUA W BAKER O.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	1826	NC

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
4	802972	OTHER	NC	PARTNERS MEDICARE CHOICE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	093JK	OTHER	NC	BLUE CROSS OF NC
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	B9146	OTHER	NC	MEDCOST

General Provider Information

NPI Number	:	1679577027
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOSHUA W BAKER O.D.

Provider Business Mailing Address
First Line	:	820 LOWER DALLAS HWY
Second Line	:
City	:	DALLAS
State	:	NC
Zip	:	28034
Country	:	US
Telephone Number	:	704-922-9808
Fax Number	:	704-922-8213

Provider Business Practice Location Address
First Line	:	820 LOWER DALLAS HWY
Second Line	:
City	:	DALLAS
State	:	NC
Zip	:	28034
Country	:	US
Telephone Number	:	704-922-9808
Fax Number	:	704-922-8213

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/13/2005
Last Update Date	:	03/12/2008

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Directions to “ DR. JOSHUA W BAKER O.D.” Practice Location

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