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General NPI Number Information
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NPI Number | 1285141739
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Entity Type | Individual
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Provider Name | LOGAN MCKINLEY BAIRD
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Gender | Male
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Dates
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Enumeration Date | 01/05/2018
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Last Update Date | 01/05/2018
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Provider Practice Location Address
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Address Line | 18157 ALBERTA ST
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City | ONEIDA
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State | TN
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Zip | 37841-6201
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Country | US
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Telephone | 423-569-5555
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Fax |
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Provider Business Mailing Address
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Address Line | 146 ROLLING HILLS LN
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City | JACKSBORO
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State | TN
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Zip | 37757-2595
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Country | US
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Telephone | 423-494-4969
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 41327
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License Number State | TN
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