Individual
JONATHAN C BAKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
RIVERSIDE PEDIATRICS, 9659 RIVERSIDE DR, TULSA, OK 74137-7305
(918) 299-5040
(918) 299-9041
Mailing address
RIVERSIDE PEDIATRICS, 9659 RIVERSIDE DR, TULSA, OK 74137-7305
(918) 299-5040
(918) 299-9041
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
15100
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100123970A
—
OK
Enumeration date
04/03/2006
Last updated
01/20/2017
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