Individual
DR. MARK BLAIR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
100 WILLIAM NORTHERN BLVD, TULLAHOMA, TN 37388-4754
(931) 461-1150
(888) 498-3372
Mailing address
PO BOX 910, TULLAHOMA, TN 37388-0910
(931) 461-1150
(888) 498-3372
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
MD34454
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
020053847
IND RRMCR #
TN
05
—
3856436
—
TN
01
—
4043202
BCBS OF TN
TN
01
—
7201687
CIGNA HEALTHCARE
TN
Enumeration date
05/24/2005
Last updated
02/15/2023
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