Individual
DR. BRYAN M BLAIR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6400 WESTWIND WAY, CRESTWOOD, KY 40014-6773
(502) 243-2227
(502) 243-2237
Mailing address
6400 WESTWIND WAY, CRESTWOOD, KY 40014-6773
(502) 243-2227
(502) 243-2237
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
35792
KY
207W00000X
Ophthalmology Physician
BB6817196
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1177630003
MEDICARE DME MAC
KY
05
—
300050706
—
IN
05
—
64066624
—
KY
01
—
P00041810
MEDICARE RAILROAD
KY
Enumeration date
10/12/2005
Last updated
06/10/2021
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