Provider Demographics
NPI:1952594376
Name:BAIER, CRAIG WILLIAM (OD)
Entity Type:Individual
Prefix:
First Name:CRAIG
Middle Name:WILLIAM
Last Name:BAIER
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 1:515 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:KS
Mailing Address - Zip Code:67114-2256
Mailing Address - Country:US
Mailing Address - Phone:316-283-2112
Mailing Address - Fax:316-283-0600
Practice Address - Street 1:515 N MAIN ST
Practice Address - Street 2:
Practice Address - City:NEWTON
Practice Address - State:KS
Practice Address - Zip Code:67114-2256
Practice Address - Country:US
Practice Address - Phone:316-283-2112
Practice Address - Fax:316-283-0600
Is Sole Proprietor?:No
Enumeration Date:2007-08-20
Last Update Date:2022-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1762152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS200442820AMedicaid
KS200442820AMedicaid