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General NPI Number Information
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NPI Number | 1164971685
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Entity Type | Organization
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Legal Business Name | BAIRD OPTICAL CO INC
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Dates
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Enumeration Date | 09/26/2016
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Last Update Date | 02/24/2017
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Provider Practice Location Address
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Address Line | 1570 EGYPT RD STE 250
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City | PHOENIXVILLE
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State | PA
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Zip | 19460-1193
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Country | US
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Telephone | 610-650-6888
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Fax |
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Provider Business Mailing Address
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Address Line | 1570 EGYPT RD STE 250
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City | PHOENIXVILLE
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State | PA
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Zip | 19460-1193
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Country | US
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Telephone | 610-650-6888
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. LUCAS R BAIRD
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Credential | OD
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Telephone | 814-207-6526
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number |
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License Number State |
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