Healthcare Provider Details

I. General information

NPI: 1013069699
Provider Name (Legal Business Name): ROBERT CATON BAKER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/17/2007
Last Update Date: 03/15/2024
Certification Date: 03/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2601 GENE GEORGE BLVD
SPRINGDALE AR
72762-0845
US

IV. Provider business mailing address

2601 GENE GEORGE BLVD
SPRINGDALE AR
72762-0845
US

V. Phone/Fax

Practice location:
  • Phone: 479-725-6800
  • Fax: 479-725-6582
Mailing address:
  • Phone: 479-725-6800
  • Fax: 479-725-6582

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LP3000X
TaxonomyPediatric Anesthesiology Physician
License NumberE-5227
License Number StateAR
# 2
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberE-5227
License Number StateAR
# 3
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number0101248865
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: