Individual
EVAN TODD BLAIR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
140 BURKE CALHOUN CITY RD, CALHOUN CITY, MS 38916-9690
(662) 842-1758
(662) 628-6300
Mailing address
965 RIDGE LAKE BLVD STE 315, MEMPHIS, TN 38120-9401
(901) 227-7015
(901) 227-8591
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
MD.45941
AL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/26/2018
Last updated
04/15/2024
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