Provider Demographics
NPI:1730177577
Name:LAIRD, MARTHA E (MD)
Entity type:Individual
Prefix:
First Name:MARTHA
Middle Name:E
Last Name:LAIRD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2424 N WYATT DR
Mailing Address - Street 2:STE. 260
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85712-6115
Mailing Address - Country:US
Mailing Address - Phone:520-795-0549
Mailing Address - Fax:520-795-0354
Practice Address - Street 1:6261 N LA CHOLLA BLVD STE 277
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85741-3564
Practice Address - Country:US
Practice Address - Phone:520-877-3800
Practice Address - Fax:520-877-3801
Is Sole Proprietor?:No
Enumeration Date:2005-10-06
Last Update Date:2021-01-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ25704207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ45885301Medicaid
AZZ130267OtherMEDICARE
AZZ130267OtherMEDICARE