Individual
DENNIS ALVIN BAXLEY
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
1000 E 1ST ST, STE 400, DULUTH, MN 55805-2297
(218) 722-5513
(218) 722-6515
Mailing address
1000 E 1ST ST, STE 400, DULUTH, MN 55805-2297
(218) 722-5513
(218) 722-6515
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
8897
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
73A55BA
BLUE SHIELD
MN
01
—
98527100845
PREFERREDONE
MN
Enumeration date
06/24/2005
Last updated
07/08/2007
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