Provider Demographics
NPI:1336136530
Name:BAKER, ROBERT V (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:V
Last Name:BAKER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1215 SIDNEY ST
Mailing Address - Street 2:SUITE 300
Mailing Address - City:BATESVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72501-7203
Mailing Address - Country:US
Mailing Address - Phone:870-793-1126
Mailing Address - Fax:870-793-1180
Practice Address - Street 1:1215 SIDNEY ST
Practice Address - Street 2:SUITE 300
Practice Address - City:BATESVILLE
Practice Address - State:AR
Practice Address - Zip Code:72501-7203
Practice Address - Country:US
Practice Address - Phone:870-793-1126
Practice Address - Fax:870-793-1180
Is Sole Proprietor?:No
Enumeration Date:2005-10-03
Last Update Date:2010-06-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ARC5833207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR13295000000OtherQUALCHOICE
AR4365300OtherAETNA
AR102765001Medicaid
D04328Medicare UPIN
ARD04328Medicare UPIN
AR102765001Medicaid