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Individual

DR. COURTNEY JACKSON BLAIR

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
6888 ELM ST STE 301, MC LEAN, VA 22101-3829
(703) 356-8290
(703) 356-8031
Mailing address
1360 BEVERLY RD, STE 103, MC LEAN, VA 22101-3621
(703) 356-8290
(703) 356-8031

Taxonomy

Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
0101243347
VA
207R00000X
Internal Medicine Physician
36113297
IL
208000000X
Pediatrics Physician
36113297
IL

Other

Enumeration date
06/11/2006
Last updated
02/29/2016
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