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Individual

SUSAN DIANE BLAIR

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
4200 N RODNEY PARHAM RD STE 101, LITTLE ROCK, AR 72212-2458
(501) 224-5658
(501) 224-8114
Mailing address
201 EXECUTIVE CT STE A, LITTLE ROCK, AR 72205-4536
(501) 224-5658
(501) 223-8656

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
C7661
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
08-20033
UNITED HEALTHCARE
AR
01
11825
COORDINATED VISION CARE
AR
05
125599001
AR
01
13629000000
QUALCHOICE
AR
01
180030604
RAILROAD MEDICARE
AR
01
2454752
CIGNA
AR
01
4514242
AETNA
AR
01
54157
BLUE CROSS OF AR
AR
01
5B955
BLUE CROSS PAY TO PROVIDE
AR
01
C7661
STATE MEDICAL BOARD
AR
01
CJ3133
RR MEDICARE GROUP #
AR
Enumeration date
07/15/2005
Last updated
04/15/2025
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