Provider Demographics
NPI:1972035152
Name:BAXLEY PRIMARY CARE, PC
Entity Type:Organization
Organization Name:BAXLEY PRIMARY CARE, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JANEY
Authorized Official - Middle Name:B
Authorized Official - Last Name:BRITT
Authorized Official - Suffix:
Authorized Official - Credentials:FNP-C
Authorized Official - Phone:912-705-6866
Mailing Address - Street 1:950 S MAIN ST
Mailing Address - Street 2:SUITE 1
Mailing Address - City:BAXLEY
Mailing Address - State:GA
Mailing Address - Zip Code:31513-0162
Mailing Address - Country:US
Mailing Address - Phone:912-705-6866
Mailing Address - Fax:912-705-6681
Practice Address - Street 1:950 S MAIN ST
Practice Address - Street 2:SUITE 1
Practice Address - City:BAXLEY
Practice Address - State:GA
Practice Address - Zip Code:31513-0162
Practice Address - Country:US
Practice Address - Phone:912-705-6866
Practice Address - Fax:912-705-6681
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-28
Last Update Date:2017-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN115507363LF0000X, 363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Multi-Specialty