Individual
DR. GARY S BAXTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2227 US HIGHWAY 41 N, TIFTON, GA 31794
(229) 386-4200
(229) 386-5571
Mailing address
907 18TH ST E, SUITE 150, TIFTON, GA 31794-3643
(229) 353-3422
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
26452
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00450051B
—
GA
05
—
00450051C
—
GA
01
—
26452
STATE LICENSE
GA
Enumeration date
08/15/2005
Last updated
11/19/2020
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