Individual
DR. BRANDON A. BLAIR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
1511 M ST, BOX 263, ORD, NE 68862-1428
(308) 728-3229
(308) 728-5908
Mailing address
1511 M ST, BOX 263, ORD, NE 68862-1428
(308) 728-3229
(308) 728-5908
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1158
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
06753
BLUE CROSS BLUE SHIELD
NE
05
—
47063736302
—
NE
05
—
47063736303
—
NE
Enumeration date
07/26/2005
Last updated
08/09/2011
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