Provider Demographics
NPI:1619954419
Name:BAIRD CHIROPRACTIC CENTER INC.
Entity Type:Organization
Organization Name:BAIRD CHIROPRACTIC CENTER INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GUY
Authorized Official - Middle Name:THOMPSON
Authorized Official - Last Name:BAIRD
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:580-255-7224
Mailing Address - Street 1:1109 W WALNUT AVE
Mailing Address - Street 2:
Mailing Address - City:DUNCAN
Mailing Address - State:OK
Mailing Address - Zip Code:73533-4545
Mailing Address - Country:US
Mailing Address - Phone:580-255-7224
Mailing Address - Fax:580-255-7891
Practice Address - Street 1:1109 W WALNUT AVE
Practice Address - Street 2:
Practice Address - City:DUNCAN
Practice Address - State:OK
Practice Address - Zip Code:73533-4545
Practice Address - Country:US
Practice Address - Phone:580-255-7224
Practice Address - Fax:580-255-7891
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-22
Last Update Date:2008-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2236111NN0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NN0400XChiropractic ProvidersChiropractorNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OKT75257Medicare UPIN