Provider Demographics
NPI:1801631353
Name:BAKER, ALEXA MORGAN (DO)
Entity type:Individual
Prefix:MRS
First Name:ALEXA
Middle Name:MORGAN
Last Name:BAKER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:MISS
Other - First Name:ALEXA
Other - Middle Name:MORGAN
Other - Last Name:POWELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:18786 S BRYANT RD
Mailing Address - Street 2:
Mailing Address - City:TAHLEQUAH
Mailing Address - State:OK
Mailing Address - Zip Code:74464-1096
Mailing Address - Country:US
Mailing Address - Phone:918-949-0828
Mailing Address - Fax:
Practice Address - Street 1:1111 W 17TH ST
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74107-1886
Practice Address - Country:US
Practice Address - Phone:918-525-6191
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-26
Last Update Date:2024-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program