Organization
JOHN M LAIRD INC
Active
Organization
JOHN M LAIRD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN M LAIRD JR. MD (INTERNAL MEDICINE PHYSICIAN)
(314) 872-3620
Entity
Organization
Contact information
Practice address
3009 N BALLAS ROAD, SUITE 230A, ST LOUIS, MO 63131-2322
(314) 872-3620
(314) 872-9003
Mailing address
3009 N BALLAS ROAD, SUITE 230A, ST LOUIS, MO 63131-2322
(314) 872-3620
(314) 872-9003
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
M028214
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000015664
MEDICARE PTAN
MO
01
—
100848
HEALTHLINK
MO
01
—
110234947
RAILROAD MEDICARE
MO
Enumeration date
03/29/2007
Last updated
01/07/2010
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