Blair, Gordon R
Blair, Gordon R is an individual health care provider with primary practice located at 1701 Main Ave Sw Suite A, Cullman AL 35055-5299. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as his primary health care specialty. Blair, Gordon R can be contacted via phone (256) 737-0880.Contact Information
Primary practice address
1701 Main Ave Sw Suite A
Cullman AL 35055-5299
Phone: (256) 737-0880
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | 1046758 | Alabama |
Profile Details
| NPI number | 1275633893 |
|---|---|
| LBN Legal business name | Blair, Gordon R |
| Credentials | CRNP |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 24th, 2006 |
| Last updated | Apr 18th, 2008 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1275633893 | NPPES |
| Alabama | Other | 1046758 | LICENSE NUMBER |
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