Provider Demographics
NPI:1770895161
Name:BAIRD, JOHN OLIVER (DC)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:OLIVER
Last Name:BAIRD
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 1:309 W MILLBROOK RD STE 199
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27609-4394
Mailing Address - Country:US
Mailing Address - Phone:919-788-8881
Mailing Address - Fax:919-788-8818
Practice Address - Street 1:309 W MILLBROOK RD STE 199
Practice Address - Street 2:SUITE 199
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27609-4394
Practice Address - Country:US
Practice Address - Phone:919-788-8881
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-14
Last Update Date:2012-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4072111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1770895161OtherBCBS
NC5919776Medicaid
NC790201UOtherMEDICAID GROUP
NC0201UOtherBCBS GROUP
NC2346483OtherMEDICARE GROUP
NC5919776Medicaid