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:
Health care specialties
| Specialty | Code | License # | 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 7 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 | 1790769701 | NPPES |
| Missouri | MEDICAID | 207965708 | |
| Missouri | Other | 5388 |
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