Provider Demographics
NPI:1689646663
Name:BAIRD, KARL MATTHEW (MD)
Entity Type:Individual
Prefix:DR
First Name:KARL
Middle Name:MATTHEW
Last Name:BAIRD
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 1:414 ZEAGLER DR
Mailing Address - Street 2:
Mailing Address - City:PALATKA
Mailing Address - State:FL
Mailing Address - Zip Code:32177-3815
Mailing Address - Country:US
Mailing Address - Phone:386-328-4123
Mailing Address - Fax:386-328-4125
Practice Address - Street 1:414 ZEAGLER DR
Practice Address - Street 2:
Practice Address - City:PALATKA
Practice Address - State:FL
Practice Address - Zip Code:32177-3815
Practice Address - Country:US
Practice Address - Phone:386-328-4123
Practice Address - Fax:386-328-4125
Is Sole Proprietor?:No
Enumeration Date:2006-02-03
Last Update Date:2023-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD61420345207X00000X
OH35.096825207X00000X
CODR.0071085207X00000X
IN01038569A207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL020148900Medicaid
WA2242248Medicaid
FLIW471ZOtherMEDICARE
OH979866Medicaid
IN000000767646OtherANTHEM PROVIDER ID
IN10382440Medicaid