# BLAIR MEDICAL ASSOCIATES

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1336282698
- **Authorized official:** JENNIFER L BRYAN (PROJECTS MGR.)
- **Authorized official phone:** (814) 949-7621

## Contact information

- **Practice address:** 149 DEVILLE DRIVE, DUNCANSVILLE, PA 16635
- **Practice address phone:** (814) 693-0628
- **Practice address fax:** (814) 693-0637
- **Mailing address:** 1414 9TH AVE, STATION MEDICAL CENTER, ALTOONA, PA 16602-2415
- **Mailing address phone:** (814) 946-1655
- **Mailing address fax:** (814) 949-7616

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 208000000X | Pediatrics Physician | — | NULL | — |
| 208000000X | Pediatrics Physician | — | — | — |

## Other

- **Enumeration date:** 02/15/2007
- **Last updated:** 10/22/2012

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1007393100024 | — | PA |
| 05 | — | 1007393100025 | — | PA |
| 01 | — | 1508647 | GATEWAY FP NUMBER | PA |
| 01 | — | 1530694 | GATEWAY PEDS NUMBER | PA |
| 01 | — | W442 | GEISINGER OFFICE NO | PA |