Provider Demographics
NPI:1801931480
Name:BAXTER, JAMES CHAD (RT)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:CHAD
Last Name:BAXTER
Suffix:
Gender:M
Credentials:RT
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 217
Mailing Address - Street 2:
Mailing Address - City:HAMPTON
Mailing Address - State:TN
Mailing Address - Zip Code:37658-0217
Mailing Address - Country:US
Mailing Address - Phone:423-725-2339
Mailing Address - Fax:423-725-2339
Practice Address - Street 1:1233 SW AVE EXT
Practice Address - Street 2:
Practice Address - City:JOHNSON CITY
Practice Address - State:TN
Practice Address - Zip Code:37604
Practice Address - Country:US
Practice Address - Phone:423-979-3200
Practice Address - Fax:423-979-3261
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TN2067247100000X, 2471C3402X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered247100000XTechnologists, Technicians & Other Technical Service ProvidersRadiologic Technologist
Not Answered2471C3402XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistRadiography