# DR. JACE A BIRD

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1477627982
- **Gender:** Man
- **Credential:** DO

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 12468 | MT | Yes |
| 207Q00000X | Family Medicine Physician | 45865 | WI | — |

## Other

- **Enumeration date:** 11/17/2006
- **Last updated:** 01/28/2022