Provider Demographics
NPI:1306838446
Name:BAIER, LOUIS PHILIP (OD)
Entity Type:Individual
Prefix:DR
First Name:LOUIS
Middle Name:PHILIP
Last Name:BAIER
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10845 LONGSHORE WAY EAST
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34119-7976
Mailing Address - Country:US
Mailing Address - Phone:239-287-2707
Mailing Address - Fax:
Practice Address - Street 1:4161 TAMIAMI TRAIL
Practice Address - Street 2:UNIT 4
Practice Address - City:PORT CHARLOTTE
Practice Address - State:FL
Practice Address - Zip Code:33952
Practice Address - Country:US
Practice Address - Phone:941-235-2710
Practice Address - Fax:941-235-2712
Is Sole Proprietor?:No
Enumeration Date:2005-08-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY970DT152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY77009102Medicaid
KY0941012Medicare ID - Type Unspecified
KY77009102Medicaid