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NPI Code Detail

MEDICARE: SEAN BLAIR BAKER D.O.

MEDICARE: SEAN BLAIR BAKER D.O.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine PhysicianE-5501AR

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1508060641
Entity Type Code : Individual
Provider Name (Legal Business Name) : SEAN BLAIR BAKER D.O.
Provider Business Mailing Address
First Line : 3700 CLIFF DR
Second Line :
City : FORT SMITH
State : AR
Zip : 72903-5954
Country : US
Telephone Number : 479-259-9286
Fax Number :
Provider Business Practice Location Address
First Line : 7800 DALLAS ST
Second Line :
City : FORT SMITH
State : AR
Zip : 72903-4278
Country : US
Telephone Number : 479-259-9286
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/13/2007
Last Update Date : 10/30/2019

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Directions to “ SEAN BLAIR BAKER D.O.” Practice Location

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