Provider Demographics
NPI:1487431508
Name:BAKER, JOHN ROBERT (BUILDER/REMODELER)
Entity type:Individual
Prefix:MR
First Name:JOHN
Middle Name:ROBERT
Last Name:BAKER
Suffix:
Gender:M
Credentials:BUILDER/REMODELER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:605 NW 160TH ST
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73013-1025
Mailing Address - Country:US
Mailing Address - Phone:405-520-4598
Mailing Address - Fax:
Practice Address - Street 1:605 NW 160TH ST
Practice Address - Street 2:
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73013-1025
Practice Address - Country:US
Practice Address - Phone:405-520-4598
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-12
Last Update Date:2023-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171WH0202XOther Service ProvidersContractorHome Modifications