Organization
BAKER MEDICAL CORPORATION, LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RODOLFO M MANALAC MD (PRESIDENT)
(225) 775-8500
Entity
Organization
Contact information
Practice address
3034 RAY WEILAND DR, BAKER, LA 70714-3252
(225) 775-8500
(225) 775-0289
Mailing address
3034 RAY WEILAND DR, BAKER, LA 70714-3252
(225) 775-8500
(225) 775-0289
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
017057
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0856041000
BLUE CROSS
LA
05
—
1798398
—
LA
Enumeration date
05/24/2005
Last updated
05/16/2008
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