Individual
TARLTON J BLAIR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1055 N 500 W, SUITE 102 BUILDING C, PROVO, UT 84604-3305
(801) 374-2367
(801) 429-0600
Mailing address
1055 N 500 W, SUITE 102 BUILDING C, PROVO, UT 84604-3305
(801) 374-2367
(801) 429-0600
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
1731971205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
107006675102
IHC
UT
01
—
36-00170
UNITED HEALTHCARE
UT
01
—
36531
DMBA
UT
01
—
62165
PEHP
UT
05
—
870281028000
—
UT
01
—
870281028BTJ
EMIA
UT
01
—
920006303
PALMETTO
UT
01
—
QM0000042299
ALTIUS
UT
Enumeration date
09/02/2006
Last updated
03/20/2014
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