Provider Demographics
NPI:1528694544
Name:BAKER, JOVAN COLLANTES (MD)
Entity type:Individual
Prefix:DR
First Name:JOVAN
Middle Name:COLLANTES
Last Name:BAKER
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:11001 EXECUTIVE CENTER DR STE 200
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72211-4393
Mailing Address - Country:US
Mailing Address - Phone:501-585-3935
Mailing Address - Fax:501-585-2955
Practice Address - Street 1:605 SALEM RD STE B3
Practice Address - Street 2:
Practice Address - City:CONWAY
Practice Address - State:AR
Practice Address - Zip Code:72034-4863
Practice Address - Country:US
Practice Address - Phone:501-585-3935
Practice Address - Fax:501-585-2955
Is Sole Proprietor?:No
Enumeration Date:2020-03-21
Last Update Date:2023-06-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
ARE-16244207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine