Organization
JOHN V. BAKA M.D.P.A
Active
Other names
Benton Women's Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN VINCENT BAKA M.D. (PHYSICIAN)
(501) 778-1000
Entity
Organization
Contact information
Practice address
1220 MILITARY RD, BENTON, AR 72015-2908
(501) 778-1000
(501) 778-1010
Mailing address
PO BOX 604, BENTON, AR 72018-0604
(501) 778-1000
(501) 778-1010
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
E0792
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
137424002
—
AR
01
—
16839000000
QC
AR
01
—
5K157
BCBS
AR
Enumeration date
07/13/2006
Last updated
01/24/2011
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