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Individual

DR. RICHARD BLAIR

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
210 E GRAY ST STE 700, LOUISVILLE, KY 40202
(502) 629-5400
(502) 629-5492
Mailing address
PO BOX 776351, CHICAGO, IL 60677-6351
(502) 588-9490
(502) 272-5116

Taxonomy

Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
Primary
03784
KY
207QA0505X
Adult Medicine Physician
15435
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
009989045
AL
01
51527542
BLUE CROSS
AL
05
7100378800
KY
01
K188051
MEDICARE
KY
Enumeration date
06/06/2006
Last updated
04/26/2023
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