# BENJAMIN BLAIR, MD PA

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

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

## Provider details

- **NPI number:** 1497883300
- **Authorized official:** BENJAMIN BLAIR MD (PRESIDENT)
- **Authorized official phone:** (208) 233-2100

## Contact information

- **Practice address:** 2240 E CENTER ST, POCATELLO, ID 83201-2600
- **Practice address phone:** (208) 233-2100
- **Practice address fax:** (208) 233-3146
- **Mailing address:** 2240 E CENTER ST, POCATELLO, ID 83201-2600
- **Mailing address phone:** (208) 233-2100
- **Mailing address fax:** (208) 233-3146

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 174400000X | Specialist | M7032 | ID | Yes |

## Other

- **Enumeration date:** 03/01/2007
- **Last updated:** 09/07/2021

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 0000100002014 | BLUE SHIELD OF IDAHO | ID |
| 05 | — | 002756000 | — | ID |
| 01 | — | 185513400 | US DEPT OF LABOR | — |
| 01 | — | 8K305 | BLUE CROSS GROUP ID \# | ID |
| 01 | — | DA7257 | RAILROAD MEDICARE GRP ID | — |