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General NPI Number Information
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NPI Number | 1255892113
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Entity Type | Individual
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Provider Name | JOSHUA RYAN BAKER DO
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Gender | Male
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Dates
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Enumeration Date | 03/25/2019
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Last Update Date | 07/19/2023
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Provider Practice Location Address
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Address Line | 744 W 9TH ST
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City | TULSA
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State | OK
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Zip | 74127-9907
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Country | US
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Telephone | 801-875-8173
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Fax |
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Provider Business Mailing Address
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Address Line | 4424 S 174TH EAST AVE
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City | TULSA
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State | OK
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Zip | 74134-7169
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Country | US
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Telephone | 801-875-8173
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State | OK
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Taxonomy #2
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 6941
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License Number State | OK
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