Individual
MR. BAXTER HEFLIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
405 W JACKSON ST, CARBONDALE, IL 62901-1462
(618) 549-0721
(618) 457-0469
Mailing address
PO BOX 3988, CARBONDALE, IL 62902-3988
(618) 457-5200
(618) 351-4821
Taxonomy
Speciality
Code
Description
License number
State
163WE0003X
Emergency Registered Nurse
041443720
IL
363L00000X
Nurse Practitioner
Primary
209031412
IL
Other
Enumeration date
10/01/2024
Last updated
03/20/2025
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