Provider Demographics
NPI:1942332523
Name:BAXTER, BARBARA R (PA)
Entity Type:Individual
Prefix:MRS
First Name:BARBARA
Middle Name:R
Last Name:BAXTER
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:112 MAPLE ST
Mailing Address - Street 2:
Mailing Address - City:WEST ROXBURY
Mailing Address - State:MA
Mailing Address - Zip Code:02132-1844
Mailing Address - Country:US
Mailing Address - Phone:617-327-5537
Mailing Address - Fax:508-222-7034
Practice Address - Street 1:687 N MAIN ST
Practice Address - Street 2:
Practice Address - City:ATTLEBORO
Practice Address - State:MA
Practice Address - Zip Code:02703-1518
Practice Address - Country:US
Practice Address - Phone:508-222-3200
Practice Address - Fax:508-222-7034
Is Sole Proprietor?:No
Enumeration Date:2007-03-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA370363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical