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General NPI Number Information
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NPI Number | 1548482938
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Entity Type | Organization
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Legal Business Name | BAKER EYE CARE
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Dates
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Enumeration Date | 05/03/2007
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Last Update Date | 04/21/2009
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Provider Practice Location Address
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Address Line | 12880 PLANK RD
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City | BAKER
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State | LA
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Zip | 70714
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Country | US
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Telephone | 225-775-3994
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Fax | 225-775-2190
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Provider Business Mailing Address
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Address Line | 12880 PLANK RD
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City | BAKER
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State | LA
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Zip | 70714
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Country | US
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Telephone | 225-775-3994
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Fax | 225-775-2190
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | LISA WHITE
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Credential |
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Telephone | 225-664-2189
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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 |
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License Number State |
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