MEDICARE: BAKER O & P ENTERPRISES, INC.

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
1	335E00000X	Prosthetic/Orthotic Supplier

General Provider Information

NPI Number	:	1518573799
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BAKER O & P ENTERPRISES, INC.

Provider Business Mailing Address
First Line	:	102 WOODMONT BLVD STE 120
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37205-5249
Country	:	US
Telephone Number	:	615-864-8790
Fax Number	:

Provider Business Practice Location Address
First Line	:	2611 E 29TH ST
Second Line	:
City	:	BRYAN
State	:	TX
Zip	:	77802-2502
Country	:	US
Telephone Number	:	979-704-6309
Fax Number	:

Authorized Official
Title or Position	:	VP OF FINANCE, CONTROLLER
Name	:	AARON KRATOHVIL
Credential	:
Telephone Number	:	615-550-8760

Provider Enumeration Date	:	09/22/2020
Last Update Date	:	09/22/2020

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Directions to “BAKER O & P ENTERPRISES, INC. ” Practice Location

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