Individual
DR. BLAKE ALLEN BAIRD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
505 N 14TH ST, PERRY, OK 73077-5000
(580) 336-3529
(580) 336-2409
Mailing address
505 N 14TH ST, STE C, PERRY, OK 73077-5000
(580) 336-3529
(580) 336-2409
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
16124
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100196260A
—
OK
01
—
731341903
TAX ID
OK
Enumeration date
05/24/2005
Last updated
01/11/2017
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