Provider Demographics
NPI:1356560064
Name:BIRD, JEFFREY K (DC)
Entity type:Individual
Prefix:
First Name:JEFFREY
Middle Name:K
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 1:3143 WESTERN ROW RD
Mailing Address - Street 2:STE A
Mailing Address - City:MAINEVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45039-9509
Mailing Address - Country:US
Mailing Address - Phone:513-755-3354
Mailing Address - Fax:513-755-8021
Practice Address - Street 1:9494 CINCINNATI COLUMBUS RD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45241-1161
Practice Address - Country:US
Practice Address - Phone:513-755-3354
Practice Address - Fax:513-755-8021
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-24
Last Update Date:2021-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3198111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000302745OtherANTHEM PIN NUMBER