Healthcare Provider Details
I. General information
NPI: 1922014976
Provider Name (Legal Business Name): TIMOTHY NORMAN BAXTER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 07/31/2006
Last Update Date: 04/01/2025
Certification Date: 04/01/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1851 N MCKENZIE ST STE 200
FOLEY AL
36535-4700
US
IV. Provider business mailing address
PO BOX 689022
FRANKLIN TN
37068-9022
US
V. Phone/Fax
- Phone: 251-424-1232
- Fax: 251-424-1954
- Phone: 615-465-7390
- Fax: 615-628-6877
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | 176697 |
| License Number State | NY |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | MD.50164 |
| License Number State | AL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: