Provider Demographics
NPI:1730103060
Name:BAXTER, RICHARD EARL (PT, DSC, OCS, ATC)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:EARL
Last Name:BAXTER
Suffix:
Gender:M
Credentials:PT, DSC, OCS, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 CAISSON HILL RD, ATTN: MCXX-CLD-QM (CRED)
Mailing Address - Street 2:IRWIN ARMY COMMUNITY HOSPITAL
Mailing Address - City:FORT RILEY
Mailing Address - State:KS
Mailing Address - Zip Code:66442-5037
Mailing Address - Country:US
Mailing Address - Phone:785-239-7155
Mailing Address - Fax:785-239-7364
Practice Address - Street 1:600 CAISSON HILL RD, ATTN: MCXX-CLD-QM (CRED)
Practice Address - Street 2:IRWIN ARMY COMMUNITY HOSPITAL
Practice Address - City:FORT RILEY
Practice Address - State:KS
Practice Address - Zip Code:66442-5037
Practice Address - Country:US
Practice Address - Phone:785-239-7155
Practice Address - Fax:785-239-7364
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX140842225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist