Healthcare Provider Details

I. General information

NPI: 1891758074
Provider Name (Legal Business Name): KAREN F BAKER M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 04/10/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2710 COLLEGE AVE
CONWAY AR
72034-6141
US

IV. Provider business mailing address

PO BOX 1210
CONWAY AR
72033-1210
US

V. Phone/Fax

Practice location:
  • Phone: 501-329-1800
  • Fax: 501-329-2507
Mailing address:
  • Phone: 501-329-1800
  • Fax: 501-329-2507

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberE2156
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: