Healthcare Provider Details

I. General information

NPI: 1538230263
Provider Name (Legal Business Name): DOUGLAS MURRAY BAIRD III DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/13/2006
Last Update Date: 11/20/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13540 WALSINGHAM RD
LARGO FL
33774-3546
US

IV. Provider business mailing address

13540 WALSINGHAM RD
LARGO FL
33774-3546
US

V. Phone/Fax

Practice location:
  • Phone: 727-593-5492
  • Fax: 727-593-5440
Mailing address:
  • Phone: 727-593-5492
  • Fax: 727-593-5440

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License NumberOS2471
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: