Individual
LORI A BAXTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D., FAAP
Contact information
Practice address
CEDAR CREEK PEDIATRIC & ADOLESCENT MEDICINE, PC, 616 SMITHVIEW DRIVE, MARYVILLE, TN 37803-6100
(865) 379-2277
(865) 738-0087
Mailing address
CEDAR CREEK PEDIATRIC & ADOLESCENT MEDICINE, PC, 616 SMITHVIEW DRIVE, MARYVILLE, TN 37803-2100
(865) 379-2277
(865) 738-0087
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MD21610
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3061228
MEDICAID
TN
01
—
MD21610
MEDICAL LICESNE NUMBER
TN
Enumeration date
06/16/2006
Last updated
03/07/2023
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