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NPI Code Detail

MEDICARE: DOUGLAS O. BAXLEY CRNA

MEDICARE: DOUGLAS O. BAXLEY CRNA
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
1367500000XCertified Registered Nurse Anesthetist1-056701AL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1912956939
Entity Type Code : Individual
Provider Name (Legal Business Name) : DOUGLAS O. BAXLEY CRNA
Provider Business Mailing Address
First Line : 285 RHETT CIR
Second Line :
City : JACKSON
State : AL
Zip : 36545-8703
Country : US
Telephone Number : 251-246-9594
Fax Number :
Provider Business Practice Location Address
First Line : 247 S MAIN ST
Second Line :
City : REIDSVILLE
State : GA
Zip : 30453-4605
Country : US
Telephone Number : 912-557-1000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/08/2006
Last Update Date : 10/17/2025

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Directions to “ DOUGLAS O. BAXLEY CRNA” Practice Location

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