MEDICARE: DR. MAJOR ELLIOTT BLAIR JR. MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207X00000X	Orthopaedic Surgery Physician	MD203742	LA
2	207X00000X	Orthopaedic Surgery Physician	MDG1331	TX

General Provider Information

NPI Number	:	1124027479
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MAJOR ELLIOTT BLAIR JR. MD

Provider Business Mailing Address
First Line	:	PO BOX 3046
Second Line	:
City	:	MALVERN
State	:	PA
Zip	:	19355-0746
Country	:	US
Telephone Number	:	806-398-3627
Fax Number	:	806-351-7801

Provider Business Practice Location Address
First Line	:	3501 S SONCY RD STE 104
Second Line	:
City	:	AMARILLO
State	:	TX
Zip	:	79119-6405
Country	:	US
Telephone Number	:	806-398-3627
Fax Number	:	806-351-7801

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/19/2005
Last Update Date	:	08/24/2020

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