Healthcare Provider Details

I. General information

NPI: 1891786612
Provider Name (Legal Business Name): BAKER EYE INSTITUTE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/01/2005
Last Update Date: 01/09/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

810 MERRIMAN ST
CONWAY AR
72032-4436
US

IV. Provider business mailing address

810 MERRIMAN ST
CONWAY AR
72032-4436
US

V. Phone/Fax

Practice location:
  • Phone: 501-932-0118
  • Fax: 501-932-0070
Mailing address:
  • Phone: 501-932-0118
  • Fax: 501-932-0070

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. DAVID LITTLETON BAKER JR.
Title or Position: CLINIC OWNER OPHTHALMOLOGIST
Credential: MD
Phone: 501-932-0118