Individual
RICKY W BARON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
710 S 13TH ST, DECATUR, IN 46733-1802
(260) 724-4318
(260) 724-9776
Mailing address
PO BOX 549, WABASH, IN 46992-0549
(260) 569-9550
(260) 569-0760
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
18001733B
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000084907
ANTHEM BCBS
IN
05
—
100146650A
—
IN
05
—
300009935
—
IN
01
—
5348017
AETNA
IN
Enumeration date
09/29/2005
Last updated
05/01/2018
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