Provider Demographics
NPI:1912991837
Name:BAER, SCOTT LLOYD (OD)
Entity Type:Individual
Prefix:
First Name:SCOTT
Middle Name:LLOYD
Last Name:BAER
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:90 VERMONT AVE
Mailing Address - Street 2:THE EYE CENTER OF OAK RIDGE PC
Mailing Address - City:OAK RIDGE
Mailing Address - State:TN
Mailing Address - Zip Code:37830-6478
Mailing Address - Country:US
Mailing Address - Phone:865-482-8890
Mailing Address - Fax:865-482-7400
Practice Address - Street 1:90 VERMONT AVE
Practice Address - Street 2:THE EYE CENTER OF OAK RIDGE PC
Practice Address - City:OAK RIDGE
Practice Address - State:TN
Practice Address - Zip Code:37830-6478
Practice Address - Country:US
Practice Address - Phone:865-482-8890
Practice Address - Fax:865-482-7400
Is Sole Proprietor?:No
Enumeration Date:2005-09-07
Last Update Date:2009-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNOD0000001476152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3599255Medicaid
TN3599255Medicaid
U48531Medicare UPIN