| Baker Vision Clinic, Inc. | |
| 2150 3rd St, Baker City, OR 97814-2609 | |
| (541) 523-5858 | |
| (541) 523-7652 | 
| Full Name | Baker Vision Clinic, Inc. | 
|---|---|
| Type | Facility | 
| Speciality | Optometrist | 
| Location | 2150 3rd St, Baker City, Oregon | 
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1013063676 | NPI | - | NPPES | 
| 150745 | Medicaid | OR | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 152W00000X | Optometrist | 1773ATI (Oregon) | Primary | 
| Provider Name | Logan T Mitchell | 
|---|---|
| Provider Type | Practitioner - Optometry | 
| Provider Identifiers | NPI Number: 1831401967 PECOS PAC ID: 0547452864 Enrollment ID: I20101005000973 | 
| Provider Name | Sheryl Blankenship | 
|---|---|
| Provider Type | Practitioner - Optometry | 
| Provider Identifiers | NPI Number: 1255324158 PECOS PAC ID: 5092824300 Enrollment ID: I20110201000955 | 
| Provider Name | Leslie M Elms | 
|---|---|
| Provider Type | Practitioner - Optometry | 
| Provider Identifiers | NPI Number: 1790778231 PECOS PAC ID: 6305055617 Enrollment ID: I20110222001199 | 
| Provider Name | Derek James Blankenship | 
|---|---|
| Provider Type | Practitioner - Optometry | 
| Provider Identifiers | NPI Number: 1215414198 PECOS PAC ID: 8022357359 Enrollment ID: I20190305001439 | 
| Mailing Address | Practice Location Address | 
|---|---|
| Baker Vision Clinic, Inc. 2150 3rd St, Baker City, OR 97814-2609 Ph: (541) 523-5858 | Baker Vision Clinic, Inc. 2150 3rd St, Baker City, OR 97814-2609 Ph: (541) 523-5858 | 
| Dr. Sheryl L Blankenship, OD Optometrist Medicare: Medicare Enrolled Practice Location: 2150 3rd St, Baker City, OR 97814 Phone: 541-523-5858 Fax: 541-523-7652 | |
| Dr. Leslie M Elms, OD Optometrist Medicare: Accepting Medicare Assignments Practice Location: 2150 3rd St, Baker City, OR 97814 Phone: 541-523-5858 Fax: 541-523-7652 | |
| Logan Thompson Mitchell, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 2150 3rd St, Baker City, OR 97814 Phone: 541-523-5858 Fax: 541-523-7652 |