MEDICARE: TIFFANY A BAKER PHARM. D.

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	183500000X	Pharmacist	13234	OK

General Provider Information

NPI Number	:	1891780383
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TIFFANY A BAKER PHARM. D.

Provider Business Mailing Address
First Line	:	725 SECRETARIAT LN
Second Line	:
City	:	EDMOND
State	:	OK
Zip	:	73003-0804
Country	:	US
Telephone Number	:	405-741-1200
Fax Number	:

Provider Business Practice Location Address
First Line	:	1212A S DOUGLAS BLVD
Second Line	:
City	:	MIDWEST CITY
State	:	OK
Zip	:	73130-5213
Country	:	US
Telephone Number	:	405-741-1200
Fax Number	:

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

Provider Enumeration Date	:	09/12/2005
Last Update Date	:	07/08/2007

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Directions to “ TIFFANY A BAKER PHARM. D.” Practice Location

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