Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | MD25124 | OR |
N | 207QG0300X | Family Doctor - Geriatric Medicine | MD25124 | OR |
NPI | 1053383893 |
---|---|
Provider Name | Dr. Jeffrey G Baxter |
First Address | Eugene, OR 97402-0451 |
Second Address | Eugene, OR 97402-9757 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/02/2006 |
Last Update Date | 09/02/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
234438 | (05) | OR |
G63172 | (02) |