Provider Demographics
NPI:1962662247
Name:BIRD, BRET JAMES (DC)
Entity Type:Individual
Prefix:DR
First Name:BRET
Middle Name:JAMES
Last Name:BIRD
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 1:1201 S HIGH ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43206-3400
Mailing Address - Country:US
Mailing Address - Phone:614-444-5661
Mailing Address - Fax:614-444-5662
Practice Address - Street 1:1201 S HIGH ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43206-3400
Practice Address - Country:US
Practice Address - Phone:614-444-5661
Practice Address - Fax:614-444-5662
Is Sole Proprietor?:No
Enumeration Date:2008-06-11
Last Update Date:2008-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3916111N00000X
KS01-04563111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH$$$$$$$$$-00OtherOHIO BOARD WORKERS COMPENSATION PROVIDER
KSU81556Medicare UPIN
KS060422Medicare PIN