Provider Demographics
NPI:1750447546
Name:DIANE L BAIRD MD PC
Entity Type:Organization
Organization Name:DIANE L BAIRD MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLER/CONTRACTING COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:BREAUNA
Authorized Official - Middle Name:
Authorized Official - Last Name:GERMYN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:541-505-4134
Mailing Address - Street 1:360 S GARDEN WAY STE 210
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-8186
Mailing Address - Country:US
Mailing Address - Phone:541-683-3202
Mailing Address - Fax:541-868-1063
Practice Address - Street 1:360 S GARDEN WAY STE 210
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-8186
Practice Address - Country:US
Practice Address - Phone:541-683-3202
Practice Address - Fax:541-868-1063
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-28
Last Update Date:2023-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORDC9278OtherRAILROAD MEDICARE PIN
ORR118593Medicare ID - Type Unspecified