Individual
TIFFANY GAIL BLAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1000 N JEFFERSON ST, SAINT JAMES, MO 65559-1078
(573) 265-8840
(573) 202-2474
Mailing address
1000 N JEFFERSON ST, SAINT JAMES, MO 65559-1078
(735) 265-8840
(573) 202-2474
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2021038378
MO
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200063438
—
MO
Enumeration date
03/27/2018
Last updated
04/04/2025
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