Provider Demographics
NPI:1992875298
Name:BAIRD CHIROPRACTIC INC
Entity type:Organization
Organization Name:BAIRD CHIROPRACTIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BONNIE
Authorized Official - Middle Name:SMITHYMAN
Authorized Official - Last Name:BAIRD
Authorized Official - Suffix:
Authorized Official - Credentials:DC CCSP
Authorized Official - Phone:919-557-5811
Mailing Address - Street 1:320 N JUDD PKWY NE
Mailing Address - Street 2:STE 102
Mailing Address - City:FUQUAY VARINA
Mailing Address - State:NC
Mailing Address - Zip Code:27526-2624
Mailing Address - Country:US
Mailing Address - Phone:919-557-5811
Mailing Address - Fax:919-557-8236
Practice Address - Street 1:320 N JUDD PKWY NE
Practice Address - Street 2:STE 102
Practice Address - City:FUQUAY VARINA
Practice Address - State:NC
Practice Address - Zip Code:27526-2624
Practice Address - Country:US
Practice Address - Phone:919-557-5811
Practice Address - Fax:919-557-8236
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-08
Last Update Date:2014-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1670111N00000X, 111NS0005X, 332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NS0005XChiropractic ProvidersChiropractorSports PhysicianGroup - Multi-Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized EquipmentGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
6320398OtherCIGNA
0809AOtherBCBS
330573OtherACN
NC6210460001Medicare NSC
330573OtherACN
NC6210460001Medicare NSC