Healthcare Provider Details

I. General information

NPI: 1245454172
Provider Name (Legal Business Name): BAKER & BAKER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/12/2007
Last Update Date: 03/11/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

106 HIGHWAY 62 W
SALEM AR
72576-0247
US

IV. Provider business mailing address

PO BOX 247
SALEM AR
72576-0247
US

V. Phone/Fax

Practice location:
  • Phone: 870-895-3811
  • Fax: 870-895-3836
Mailing address:
  • Phone: 870-895-3811
  • Fax: 870-895-3836

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number1325880001
License Number State

VIII. Authorized Official

Name: DR. SCOTTY BAKER
Title or Position: P.I.C.
Credential: P.D.
Phone: 870-895-3811