Blair, Mark

Blair, Mark is an individual health care provider with primary practice located at 100 William Northern Blvd , Tullahoma TN 37388-4754. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Blair, Mark can be contacted via phone (931) 461-1150.

Contact Information

Primary practice address
100 William Northern Blvd Tullahoma TN 37388-4754
Phone: (931) 461-1150
Fax: (888) 498-3372
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X MD34454 Tennessee

Profile Details

NPI number 1508869561
LBN Legal business name Blair, Mark
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 24th, 2005
Last updated Feb 15th, 2023 - about 2 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 1508869561 NPPES
Tennessee Other 020053847 IND RRMCR #
Tennessee Other 7201687 IND RRMCR #
Tennessee MEDICAID 3856436 IND RRMCR #
Tennessee Other 4043202 IND RRMCR #

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