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General NPI Number Information
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NPI Number | 1518976091
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Entity Type | Individual
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Provider Name | CYNTHIA W. BAKER OD
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Gender | Female
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Dates
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Enumeration Date | 08/05/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1330 S RANGE AVE
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City | DENHAM SPRINGS
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State | LA
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Zip | 70726-4810
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Country | US
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Telephone | 225-664-2189
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Fax | 225-665-6309
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Provider Business Mailing Address
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Address Line | 1330 S RANGE AVE
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City | DENHAM SPRINGS
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State | LA
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Zip | 70726-4810
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Country | US
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Telephone | 225-664-2189
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Fax | 225-665-6309
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 928-208T
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License Number State | LA
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