Baxter, Kevin Ray

Baxter, Kevin Ray is an individual health care provider with primary practice located at 230 E Day Rd Ste 100, Mishawaka IN 46545-3408. He recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as his primary health care specialty. Baxter, Kevin Ray can be contacted via phone (574) 271-3939.

Contact Information

Primary practice address
230 E Day Rd Ste 100 Mishawaka IN 46545-3408
Phone: (574) 271-3939
Fax: (574) 271-3941
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X 510109282 Michigan
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X 02004614A Indiana

Profile Details

NPI number 1609161686
LBN Legal business name Baxter, Kevin Ray
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 17th, 2011
Last updated Jul 2nd, 2015 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1609161686 NPPES
Indiana MEDICAID 201292460
Indiana Other 204460004

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