Blair, Jerry R

Blair, Jerry R is an individual health care provider with primary practice located at 3600 Amron Ct , Columbia MO 65202-1918. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Retina Specialist, Allopathic & Osteopathic Physicians / Ophthalmology. Allopathic & Osteopathic Physicians / Ophthalmology is his primary health care specialty. Blair, Jerry R can be contacted via phone (573) 874-1616.

Contact Information

Primary practice address
3600 Amron Ct Columbia MO 65202-1918
Phone: (573) 874-1616
Fax: (573) 875-0300
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Retina Specialist 207WX0107X 108058 Missouri
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X 108058 Missouri

Profile Details

NPI number 1790769701
LBN Legal business name Blair, Jerry R
Credentials M.D., PH.D.
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 2nd, 2005
Last updated Apr 10th, 2017 - about 8 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1790769701 NPPES
Missouri MEDICAID 207965708
Missouri Other 5388

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