Individual
TRACY M BAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1505 E MAIN ST, STIGLER, OK 74462-2913
(918) 967-3368
(917) 967-3351
Mailing address
PO BOX 179, STIGLER, OK 74462-0179
(918) 967-4560
(918) 967-4582
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
25080
KS
207Q00000X
Family Medicine Physician
Primary
26593
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
047743
BCBS
KS
01
—
100659
HPK
KS
01
—
11001972
MULTIPLAN
KS
01
—
16936
COVENTRY
KS
05
—
200205450A
—
OK
01
—
4253
PHS
KS
Enumeration date
07/06/2006
Last updated
01/02/2014
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