Individual
BRIAN D BAXTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
1266 ESCALANTE DR STE 301, DURANGO, CO 81303-8934
(970) 828-2200
(970) 828-2201
Mailing address
1266 ESCALANTE DR STE 301, DURANGO, CO 81303-8934
(970) 828-2200
(970) 828-2201
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
OPT-2024-0014
NM
152W00000X
Optometrist
Primary
OPT.0004060
CO
152W00000X
Optometrist
R151TA719
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
051557540
—
AL
05
—
1831126697
—
AL
01
—
515-93468
BLUE CROSS BLUESHIELD
AL
01
—
P00334247
RR MEDICARE
AL
Enumeration date
06/27/2006
Last updated
01/23/2025
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