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Individual

DR. GREGORY L. BLAIR

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
7 S MICKEY MANTLE DR, SUITE 325, OKLAHOMA CITY, OK 73104-2458
(405) 232-0101
(405) 232-0102
Mailing address
PO BOX 268922, OKLAHOMA CITY, OK 73126-8922
(405) 231-3857
(405) 272-7977

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
19544
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100091280A
OK
01
OK700309
PTAN
Enumeration date
06/12/2006
Last updated
02/14/2013
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