Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111N00000X | Chiropractor | 0006947 | CO |
Y | 111N00000X | Chiropractor | 5696 | OR |
N | 111NS0005X | Chiropractic Sports Physician | 5696 | OR |
NPI | 1124464003 |
---|---|
Provider Name | Dr. Carl Robert Baird |
First Address | Portland, OR 97212-3996 |
Second Address | Portland, OR 97212-3996 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/05/2013 |
Last Update Date | 13/12/2016 |