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NPI Code Detail

MEDICARE: DR. RANDAL S BAKER MD

MEDICARE:  DR. RANDAL S BAKER  MD
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
1208600000XSurgery Physician22567OK

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1578558672
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. RANDAL S BAKER MD
Provider Business Mailing Address
First Line : 4140 W MEMORIAL RD STE 621
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73120-8365
Country : US
Telephone Number : 405-749-4231
Fax Number : 405-749-4234
Provider Business Practice Location Address
First Line : 4140 W MEMORIAL RD STE 621
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73120-8365
Country : US
Telephone Number : 405-749-4231
Fax Number : 405-749-4234
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/14/2005
Last Update Date : 03/29/2018

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Directions to “ DR. RANDAL S BAKER MD” Practice Location

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