Individual
PATRICIA JO BLAIR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
660 MASON RIDGE CENTER DR, SAINT LOUIS, MO 63141-8509
(314) 273-6481
Mailing address
660 MASON RIDGE CENTER DR, SAINT LOUIS, MO 63141-8509
(314) 273-6481
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
036155436
IL
207Q00000X
Family Medicine Physician
Primary
2000161368
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
205089105
—
MO
Enumeration date
09/01/2005
Last updated
03/07/2023
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