Individual
DR. ROGER BYRON BLAIR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
6120 ALABAMA HWY, RINGGOLD, GA 30736-2804
(706) 935-6442
(706) 935-6441
Mailing address
1434 BROADRICK DR, DALTON, GA 30720-3009
(706) 278-5961
(706) 529-9588
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
6111
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003119262B
—
GA
Enumeration date
12/30/2010
Last updated
10/05/2018
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