Provider Demographics
NPI:1043403819
Name:CRAIG W. BAIER, O.D., LLC
Entity Type:Organization
Organization Name:CRAIG W. BAIER, O.D., LLC
Other - Org Name:BAIER FAMILY OPTOMETRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:W
Authorized Official - Last Name:BAIER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:316-283-2112
Mailing Address - Street 1:515 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:KS
Mailing Address - Zip Code:67114-2256
Mailing Address - Country:US
Mailing Address - Phone:316-283-2112
Mailing Address - Fax:316-283-0600
Practice Address - Street 1:515 N MAIN ST
Practice Address - Street 2:
Practice Address - City:NEWTON
Practice Address - State:KS
Practice Address - Zip Code:67114-2256
Practice Address - Country:US
Practice Address - Phone:316-283-2112
Practice Address - Fax:316-283-0600
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-24
Last Update Date:2022-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1762152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS3000431594002Medicaid
KS200442820AMedicaid
KS651180Medicare PIN