Provider Demographics
NPI:1326089889
Name:BAIR, BOOKER TED (MD)
Entity Type:Individual
Prefix:
First Name:BOOKER
Middle Name:TED
Last Name:BAIR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4133 BOARDMAN CANFIELD RD
Mailing Address - Street 2:
Mailing Address - City:CANFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44406-9047
Mailing Address - Country:US
Mailing Address - Phone:330-726-2140
Mailing Address - Fax:330-726-4426
Practice Address - Street 1:4133 BOARDMAN CANFIELD RD
Practice Address - Street 2:
Practice Address - City:CANFIELD
Practice Address - State:OH
Practice Address - Zip Code:44406-9047
Practice Address - Country:US
Practice Address - Phone:330-726-2140
Practice Address - Fax:330-726-4426
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-08
Last Update Date:2023-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH91123208000000X
OH35085173207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine