MEDICARE: DR. MARK DUNCAN BAXTER D.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	B-168	NV
2	111N00000X	Chiropractor	11850	CA

General Provider Information

NPI Number	:	1801888128
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARK DUNCAN BAXTER D.C.

Provider Business Mailing Address
First Line	:	6332 S. RAINBOW BLVD.
Second Line	:	SUITE #120
City	:	LAS VEGAS
State	:	NV
Zip	:	89118-3235
Country	:	US
Telephone Number	:	702-891-8833
Fax Number	:	702-891-8866

Provider Business Practice Location Address
First Line	:	6332 S. RAINBOW BLVD.
Second Line	:	SUITE #120
City	:	LAS VEGAS
State	:	NV
Zip	:	89118-3235
Country	:	US
Telephone Number	:	702-891-8833
Fax Number	:	702-891-8866

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/22/2005
Last Update Date	:	08/12/2015

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