Baker, R. Wayne
Baker, R. Wayne is an individual health care provider with primary practice located at 1455A Old Mcdonough Rd.Se , Conyers GA 30094-5979. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Baker, R. Wayne can be contacted via phone (770) 922-4900.Contact Information
Primary practice address
1455A Old Mcdonough Rd.Se
Conyers GA 30094-5979
Phone: (770) 922-4900
Fax: (770) 922-1563
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 000746T | Georgia |
Profile Details
| NPI number | 1669583563 |
|---|---|
| LBN Legal business name | Baker, R. Wayne |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 31st, 2006 |
| Last updated | Dec 30th, 2014 - about 12 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1669583563 | NPPES |
| Georgia | Other | 4268778 | AETNA |
| Georgia | MEDICAID | 00003242C | AETNA |
| Georgia | Other | 11584 | AETNA |
| Georgia | Other | GA3468 | AETNA |
| Georgia | Other | 1830205 | AETNA |
| Georgia | Other | 612585 | AETNA |
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