MEDICARE: BRIAN J BLAIR 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	2080P0202X	Pediatric Cardiology Physician	34129	AZ

General Provider Information

NPI Number	:	1316998677
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRIAN J BLAIR MD

Provider Business Mailing Address
First Line	:	200 W MAGEE RD STE 160
Second Line	:
City	:	ORO VALLEY
State	:	AZ
Zip	:	85704-6493
Country	:	US
Telephone Number	:	520-620-9898
Fax Number	:	520-620-9810

Provider Business Practice Location Address
First Line	:	200 W MAGEE RD STE 160
Second Line	:
City	:	ORO VALLEY
State	:	AZ
Zip	:	85704-6493
Country	:	US
Telephone Number	:	520-620-9898
Fax Number	:	520-620-9810

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

Provider Enumeration Date	:	05/12/2006
Last Update Date	:	05/24/2021

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