Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207U00000X | Nuclear Medicine Specialist | 7034 | AZ |
NPI | 1053367938 |
---|---|
Provider Name | Howard L Baxter |
First Address | Phoenix, AZ 85006-2612 |
Second Address | Phoenix, AZ 85006-2612 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/05/2006 |
Last Update Date | 03/01/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
D43687 | (02) |