Individual
SUSAN GAY BLAIR-BUCKLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
8201 GOLF COURSE RD NW STE D, ALBUQUERQUE, NM 87120-5842
(505) 800-7070
Mailing address
4340 SAN MATEO BLVD NE, ALBUQUERQUE, NM 87110-1234
(505) 252-0599
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA2006-0025
NM
363AM0700X
Medical Physician Assistant
PA2006-0025
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
12753076
—
NM
01
—
P011039980
RR MEDICARE
NM
Enumeration date
02/02/2007
Last updated
07/28/2025
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