Provider Demographics
NPI:1063273696
Name:BAIRD, COLTON WB
Entity type:Individual
Prefix:
First Name:COLTON
Middle Name:WB
Last Name:BAIRD
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6950 TOWNSHIP ROAD 195
Mailing Address - Street 2:
Mailing Address - City:CENTERBURG
Mailing Address - State:OH
Mailing Address - Zip Code:43011-9712
Mailing Address - Country:US
Mailing Address - Phone:614-900-4497
Mailing Address - Fax:
Practice Address - Street 1:21 SYCHAR RD
Practice Address - Street 2:
Practice Address - City:MOUNT VERNON
Practice Address - State:OH
Practice Address - Zip Code:43050-1837
Practice Address - Country:US
Practice Address - Phone:614-900-4497
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-22
Last Update Date:2024-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion