Ryan Baxter

Individual provider Active NPI Student in an Organized Health Care Education/Training Program · Brooklyn, MI

NPI 1760109912 · NPPES record last updated Oct 27, 2022

Key facts

NPI
1760109912
Entity type
Individual (NPI type 1)
Primary specialty
Student in an Organized Health Care Education/Training Program 390200000X
Practice address
11301 Brooklyn Rd
Brooklyn, MI 49230-8485
Phone
(517) 592-2475
NPI assigned
Oct 27, 2022
Sex
Male
Sole proprietor
No

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Practice roles

OrganizationSpecialtyStatusNew patients
Country Market Pharmacies LLC Past
since Oct 30, 2022
Accepting new patients
Country Market Pharmacies LLC Past
since Oct 30, 2022
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Yes

Addresses

Primary practice location

11301 Brooklyn Rd
Brooklyn, MI 49230-8485

Mailing address

6451 Skylark Dr
Jackson, MI 49201-8549
Phone (517) 395-9584

Other providers in Brooklyn, MI

All providers in Brooklyn, MI · Student in an Organized Health Care Education/Training Program in Michigan

Sources for this page

Verify at the official NPI Registry.