Individual
RONAN ALEXANDER BAKKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4140 W MEMORIAL RD STE 321, OKLAHOMA CITY, OK 73120-8300
(405) 748-4726
(405) 607-8497
Mailing address
PO BOX 268984, OKLAHOMA CITY, OK 73126-8984
(405) 748-4726
(405) 607-8497
Taxonomy
Speciality
Code
Description
License number
State
207VM0101X
Maternal & Fetal Medicine Physician
Primary
32144
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200690020A
—
OK
01
—
836395
MEDICARE
OK
Enumeration date
05/31/2012
Last updated
01/10/2020
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