NPI 1669583563 · live from the CMS NPI Registry
R. Wayne Baker, OD
Optometrist in Conyers, GA. National Provider Identifier 1669583563, active.
NPI record
| NPI | 1669583563 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Optometrist 152W00000X |
| Practice location | 1455a Old Mcdonough Rd.Se, Conyers, GA 30094 |
| Practice phone | 770-922-4900 |
| Mailing address | 1455 Old Mcdonough Hwy Se Ste A, Conyers, GA 30094 |
| Enumerated | August 31, 2006 |
| Last updated | December 30, 2014 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Optometrist primary | 152W00000X | 000746T (GA) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.