Provider Demographics
NPI:1477644516
Name:BAIZE, CALVIN D (DPM)
Entity Type:Individual
Prefix:
First Name:CALVIN
Middle Name:D
Last Name:BAIZE
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1816 E. MAIN ST.
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN VIEW
Mailing Address - State:AR
Mailing Address - Zip Code:72560-2561
Mailing Address - Country:US
Mailing Address - Phone:870-345-3180
Mailing Address - Fax:870-345-3180
Practice Address - Street 1:2375 WHITE DR
Practice Address - Street 2:
Practice Address - City:BATESVILLE
Practice Address - State:AR
Practice Address - Zip Code:72501-9473
Practice Address - Country:US
Practice Address - Phone:870-345-3180
Practice Address - Fax:870-345-3180
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR264213ES0131X
CO592213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
ARP01670985OtherPALMETTO GBA MEDICARE RAILROAD
AR5AS95OtherBLUE CROSS BLUE SHIELD
AR214952717Medicaid
COU86558Medicare UPIN
CO06887872Medicaid