Organization
MARK BLAIR MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK BLAIR MD (PRESIDENT)
(931) 461-1150
Entity
Organization
Contact information
Practice address
100 WILLIAM NORTHERN BLVD, TULLAHOMA, TN 37388-4754
(931) 461-1150
(888) 498-3372
Mailing address
PO BOX 910, TULLAHOMA, TN 37388-0910
(931) 461-1150
(888) 498-3372
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3370034
—
TN
01
—
4043202
BCBS
TN
01
—
7201687
CIGNA
TN
Enumeration date
10/03/2005
Last updated
02/15/2023
Update your record
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