Provider Demographics
NPI:1679540306
Name:LAIRD, DANIAL O (MD)
Entity type:Individual
Prefix:DR
First Name:DANIAL
Middle Name:O
Last Name:LAIRD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:3157 N RAINBOW BLVD # 518
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89108-4578
Mailing Address - Country:US
Mailing Address - Phone:702-386-4700
Mailing Address - Fax:702-386-4701
Practice Address - Street 1:4175 S RILEY ST STE 102
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89147-8719
Practice Address - Country:US
Practice Address - Phone:702-202-3700
Practice Address - Fax:702-386-4701
Is Sole Proprietor?:No
Enumeration Date:2006-03-01
Last Update Date:2022-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV7912207L00000X, 207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV002018175Medicaid
NVV112730Medicare PIN
NV002018175Medicaid
NVG21847Medicare UPIN
NVV32498Medicare PIN
NV32498Medicare PIN
NVV113257Medicare PIN
NVV32498Medicare PIN