Dr Russell Barre Baker, | |
309 11th St, Carrollton, KY 41008-1435 | |
(502) 732-3280 | |
(502) 732-3284 |
Full Name | Dr Russell Barre Baker |
---|---|
Gender | Male |
Speciality | Podiatrist - Foot & Ankle Surgery |
Location | 309 11th St, Carrollton, Kentucky |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1760043822 | NPI | - | NPPES |
7100919580 | Medicaid | KY | |
300084017 | Medicaid | IN |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
213E00000X | Podiatrist | 247793 (Kentucky) | Secondary |
213ES0103X | Podiatrist - Foot & Ankle Surgery | 247793 (Kentucky) | Primary |
Provider Name | Ccmh Corporation |
---|---|
Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1225159601 PECOS PAC ID: 2365540465 Enrollment ID: O20080108000723 |
Provider Name | University Of Louisville Physicians Inc |
---|---|
Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1366722316 PECOS PAC ID: 3476725599 Enrollment ID: O20111017000036 |
Mailing Address | Practice Location Address |
---|---|
Dr Russell Barre Baker, Po Box 909, Louisville, KY 40201-0909 Ph: (502) 588-0328 | Dr Russell Barre Baker, 309 11th St, Carrollton, KY 41008-1435 Ph: (502) 732-3280 |
Louisville Podiatry Psc Podiatrist Medicare: Medicare Enrolled Practice Location: 309 11th St, Carrollton, KY 41008 Phone: 502-458-8989 Fax: 502-451-5439 | |
Ccmh Corporation Podiatrist Medicare: Not Enrolled in Medicare Practice Location: 309 11th St, Carrollton, KY 41008 Phone: 502-732-3204 Fax: 502-732-3213 |