Provider Demographics
NPI:1770972325
Name:BAIRD, LACY (PA-C)
Entity type:Individual
Prefix:MRS
First Name:LACY
Middle Name:
Last Name:BAIRD
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MISS
Other - First Name:LACY
Other - Middle Name:
Other - Last Name:KORTE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:4260 GLENDALE MILFORD RD SUITE 201
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45242
Mailing Address - Country:US
Mailing Address - Phone:513-769-2767
Mailing Address - Fax:513-733-8677
Practice Address - Street 1:4260 GLENDALE MILFORD RD
Practice Address - Street 2:SUITE 201
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45242
Practice Address - Country:US
Practice Address - Phone:513-769-2767
Practice Address - Fax:513-733-8677
Is Sole Proprietor?:No
Enumeration Date:2015-01-21
Last Update Date:2017-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH50.004201363A00000X
OH50.004201RX363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant