Provider Demographics
NPI:1467742890
Name:DR EMILY BAKER & ASSOCIATES, PC
Entity Type:Organization
Organization Name:DR EMILY BAKER & ASSOCIATES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:EMILY
Authorized Official - Middle Name:JANE
Authorized Official - Last Name:BAKER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:303-466-3845
Mailing Address - Street 1:2285 E KEN PRATT BLVD
Mailing Address - Street 2:
Mailing Address - City:LONGMONT
Mailing Address - State:CO
Mailing Address - Zip Code:80501
Mailing Address - Country:US
Mailing Address - Phone:720-652-0455
Mailing Address - Fax:303-678-1933
Practice Address - Street 1:2285 E KEN PRATT BLVD
Practice Address - Street 2:
Practice Address - City:LONGMONT
Practice Address - State:CO
Practice Address - Zip Code:80501
Practice Address - Country:US
Practice Address - Phone:720-652-0455
Practice Address - Fax:303-678-1933
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DR EMILY BAKER & ASSOCIATES, PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-04-19
Last Update Date:2011-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2433152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty