Doctor Name: | MR. TREY HERRON BAXTER |
NPI Number: | 1629231725 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | |
Business Practice Address: | 580 Springridge Rd A5 Clinton, MS - 390565671 |
Business Phone Number: | 6019412023 |
Business Fax Number: | 6019225281 |
Mailing Address: | 507 Berkshire St, CLINTON |
State: | MS |
Postal Code: | 390563826 |
Phone Number: | 6019412023 |
Fax Number: | 6019225281 |
NPI Enumeration Date: | 07/08/2008 |
NPI Last Update Date: | 07/08/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 332B00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Suppliers |
Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
Taxonomy Specialization: | |
Taxonomy Definition: | A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient |