Provider Demographics
NPI:1619588068
Name:LAIRD, KAYDEE WILLCOX (OD)
Entity Type:Individual
Prefix:DR
First Name:KAYDEE
Middle Name:WILLCOX
Last Name:LAIRD
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
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Mailing Address - Street 1:1950 OLD GALLOWS RD STE 520
Mailing Address - Street 2:
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22182-3970
Mailing Address - Country:US
Mailing Address - Phone:703-847-8899
Mailing Address - Fax:571-223-6780
Practice Address - Street 1:700 7TH ST S
Practice Address - Street 2:
Practice Address - City:CLANTON
Practice Address - State:AL
Practice Address - Zip Code:35045-3778
Practice Address - Country:US
Practice Address - Phone:205-280-0034
Practice Address - Fax:205-664-1578
Is Sole Proprietor?:No
Enumeration Date:2020-08-10
Last Update Date:2023-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALS-E55-TA-C04152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist