Healthcare Provider Details

I. General information

NPI: 1871555250
Provider Name (Legal Business Name): NATASHA E. LAIRD MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/03/2006
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

37100 N GANTZEL RD STE 106
SAN TAN VALLEY AZ
85140-7303
US

IV. Provider business mailing address

PO BOX 6730
CHANDLER AZ
85246-6730
US

V. Phone/Fax

Practice location:
  • Phone: 480-821-3616
  • Fax: 480-857-2667
Mailing address:
  • Phone: 480-821-3600
  • Fax: 480-857-2667

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number42660
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: