Individual
KYLE BLAIR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
613 N 2ND ST, ROGERS, AR 72756
(479) 878-1060
Mailing address
613 N 2ND ST, ROGERS, AR 72756-6611
(479) 878-1060
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
E11256
AR
Other
Enumeration date
05/04/2015
Last updated
07/12/2018
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