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Organization
BLAIR MEDICAL ASSOCIATES
Active
Organization
BLAIR MEDICAL ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER L. BRYAN (PROJECTS MGR.)
(814) 949-7621
Entity
Organization
Contact information
Practice address
1400 PENNSYLVANIA AVE, TYRONE, PA 16686-1728
(814) 684-2100
(814) 684-5828
Mailing address
1414 9TH AVE, STATION MEDICAL CENTER, ALTOONA, PA 16602-2415
(814) 946-1655
(814) 949-7616
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
2084N0400X
Neurology Physician
—
NULL
2084N0400X
Neurology Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1007393100025
—
PA
01
—
1015355
GATEWAY OFFICE NUMBER
PA
01
—
W413
GEISINGER OFFICE NO
PA
Enumeration date
02/22/2007
Last updated
08/08/2007
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