Individual
KELLY BAXTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
455 W BROADWAY AVE, JACKSON, WY 83001-8639
(307) 733-6111
(307) 739-6105
Mailing address
PO BOX 428, JACKSON, WY 83001-0428
(307) 739-8999
(307) 739-4811
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
13126A
WY
207Q00000X
Family Medicine Physician
DR.0062940
CO
Other
Enumeration date
03/25/2018
Last updated
01/04/2024
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