Provider Demographics
NPI:1497836928
Name:BAIRD, BRETT H (DC)
Entity Type:Individual
Prefix:DR
First Name:BRETT
Middle Name:H
Last Name:BAIRD
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 5698
Mailing Address - Street 2:
Mailing Address - City:NAVARRE
Mailing Address - State:FL
Mailing Address - Zip Code:32566-0698
Mailing Address - Country:US
Mailing Address - Phone:850-936-8664
Mailing Address - Fax:850-936-4229
Practice Address - Street 1:1796 NAVARRE SOUND CIRCLE
Practice Address - Street 2:
Practice Address - City:NAVARRE
Practice Address - State:FL
Practice Address - Zip Code:32566
Practice Address - Country:US
Practice Address - Phone:850-936-8664
Practice Address - Fax:850-936-4229
Is Sole Proprietor?:No
Enumeration Date:2006-10-18
Last Update Date:2015-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH7459111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL381084400Medicaid
FL55650ZMedicare PIN
FLU69590Medicare UPIN