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Individual

MR. KENNETH REESE BAIRD

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
1665 W LAKOTA DR, ST GEORGE, UT 84770-6649
(888) 434-8880
(885) 434-8880
Mailing address
1665 W LAKOTA DR, ST GEORGE, UT 84770-6649

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
11579540-1206
UT
363A00000X
Physician Assistant
PA0004087
CO
363A00000X
Physician Assistant
PA2699
NV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1194083295
UT
Enumeration date
04/25/2012
Last updated
11/28/2022
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