Individual
JEREMIAH BLAIR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
61 WHITCHER ST SUITE 2100, MARIETTA, GA 30060
(770) 423-0595
(678) 391-5055
Mailing address
100 STONEFOREST DR STE 130, WOODSTOCK, GA 30189-4881
(770) 423-0595
(678) 388-1627
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
9359
GA
363AS0400X
Surgical Physician Assistant
—
—
Other
Enumeration date
10/14/2019
Last updated
01/05/2026
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