Individual ProviderDennis Alvin BaxleyPhysician AssistantPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address1000 E 1st St, Ste 400, Duluth, MN 55805-2297(218) 722-5513PECOS EnrollmentBased on the most recent information from CMS, provider Dennis Alvin Baxley does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1720084593Provider TypeIndividualFull NameBaxley, Dennis AlvinCredentialP.A.GenderMaleEnumeration Date6/24/2005Last Updated7/8/2007Contact InformationPractice LocationPractice Address1000 E 1st St, Ste 400, Duluth, MN 55805-2297Phone(218) 722-5513Fax(218) 722-6515Mailing LocationMailing Address1000 E 1st St, Ste 400, Duluth, MN 55805-2297Phone(218) 722-5513Fax(218) 722-6515Provider TaxonomiesCodeDescriptionLicenseCode363AS0400XPrimaryDescriptionPhysician AssistantPhysician Assistants & Advanced Practice Nursing ProvidersLicense8897MinnesotaProvider IdentifiersIDDescriptionIssuerID98527100845DescriptionOtherIssuerPREFERREDONEMinnesotaID73A55BADescriptionOtherIssuerBLUE SHIELDMinnesota