MEDICARE: CHRISTOPHER SCOTT BAKER CADC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YA0400X	Addiction (Substance Use Disorder) Counselor		OK

General Provider Information

NPI Number	:	1194955799
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTOPHER SCOTT BAKER CADC

Provider Business Mailing Address
First Line	:	4528 S SHERIDAN RD
Second Line	:	STE 101
City	:	TULSA
State	:	OK
Zip	:	74145-1140
Country	:	US
Telephone Number	:	918-398-7979
Fax Number	:	918-619-6851

Provider Business Practice Location Address
First Line	:	4528 S SHERIDAN RD
Second Line	:	STE 101
City	:	TULSA
State	:	OK
Zip	:	74145-1140
Country	:	US
Telephone Number	:	918-398-7979
Fax Number	:	918-619-6851

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/17/2009
Last Update Date	:	07/17/2009

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