| NPI | 1730104779 |
|---|---|
| Former Name | JOHN B BAXLEY |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 16872) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: SC 8997) |
| Enumeration Date | 2006-07-12 |
| Last Update Date | 2010-10-27 |