Provider Demographics
NPI:1689772808
Name:BAKERINK, JAMES A (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:A
Last Name:BAKERINK
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 1:4785 S DURANGO DR
Mailing Address - Street 2:STE 101
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89147-8166
Mailing Address - Country:US
Mailing Address - Phone:702-889-8444
Mailing Address - Fax:702-889-8454
Practice Address - Street 1:4785 S DURANGO DR
Practice Address - Street 2:STE 101
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89147-8166
Practice Address - Country:US
Practice Address - Phone:702-889-8444
Practice Address - Fax:702-889-8454
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2012-08-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NV8328208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV003102917Medicaid
NV002019917Medicaid