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General NPI Number Information
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NPI Number | 1891786612
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Entity Type | Organization
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Legal Business Name | BAKER EYE INSTITUTE
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Dates
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Enumeration Date | 11/01/2005
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Last Update Date | 01/09/2012
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Provider Practice Location Address
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Address Line | 810 MERRIMAN ST
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City | CONWAY
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State | AR
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Zip | 72032-4436
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Country | US
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Telephone | 501-932-0118
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Fax | 501-932-0070
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Provider Business Mailing Address
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Address Line | 810 MERRIMAN ST
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City | CONWAY
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State | AR
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Zip | 72032-4436
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Country | US
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Telephone | 501-932-0118
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Fax | 501-932-0070
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Authorized Official
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Title or Position | CLINIC OWNER OPHTHALMOLOGIST
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Name | DR. DAVID LITTLETON BAKER JR.
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Credential | MD
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Telephone | 501-932-0118
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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