Provider Demographics
NPI:1699761833
Name:BAIRD, RONALD EUGENE (DO)
Entity type:Individual
Prefix:DR
First Name:RONALD
Middle Name:EUGENE
Last Name:BAIRD
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1170 SHAWNEE ST
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31419-1618
Mailing Address - Country:US
Mailing Address - Phone:912-920-0214
Mailing Address - Fax:
Practice Address - Street 1:1170 SHAWNEE ST
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31419-1618
Practice Address - Country:US
Practice Address - Phone:912-920-0214
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-09-22
Last Update Date:2024-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS009719L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0016683540001Medicaid
PAF33047Medicare UPIN
PA951889Medicare ID - Type Unspecified