Provider Demographics
NPI:1588846026
Name:ALLAN BAKER INC
Entity Type:Organization
Organization Name:ALLAN BAKER INC
Other - Org Name:KORRECT OPTIACL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:A
Authorized Official - Last Name:BAKER
Authorized Official - Suffix:
Authorized Official - Credentials:LDO
Authorized Official - Phone:502-895-2020
Mailing Address - Street 1:4036 DUTCHMANS LN
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40207-4704
Mailing Address - Country:US
Mailing Address - Phone:502-895-2020
Mailing Address - Fax:
Practice Address - Street 1:4917 DIXIE HWY STE H
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40216-2565
Practice Address - Country:US
Practice Address - Phone:502-447-2020
Practice Address - Fax:502-447-3083
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-27
Last Update Date:2021-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYKY27156FX1100X
332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes332H00000XSuppliersEyewear Supplier
No156FX1100XEye and Vision Services ProvidersTechnician/TechnologistOphthalmicGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY16739OtherSPECTERA DUPONT
KY9120628792OtherPASSPORT DUPONT
KY14602OtherSPECTERA CVILLE
KY000000213814OtherANTHEM BCBS DIXIE
KY22285OtherAVESIS PIN
KY40676OtherDAVIS
KYKY0027OtherEYEMED DUPONT
KY52900271Medicaid
KY000000210920OtherANTHEM BCBS C'VILLE
KY000000213527OtherANTHEM BCBS DUPONT
KY16740OtherSPECTERA DIXIE
KY9120628792OtherPASSPORT DUPONT
KY22285OtherAVESIS PIN