Healthcare Provider Details

I. General information

NPI: 1750345807
Provider Name (Legal Business Name): JAMES DANIEL BAXTER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/14/2006
Last Update Date: 09/30/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

705 E POPLAR AVE
SELMER TN
38375-1828
US

IV. Provider business mailing address

7100 COMMERCE WAY SUITE 180
BRENTWOOD TN
37027-2851
US

V. Phone/Fax

Practice location:
  • Phone: 731-646-2181
  • Fax:
Mailing address:
  • Phone: 615-465-7000
  • Fax: 615-465-3007

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberMD0000039152
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: