MEDICARE: DR. STEPHANIE MCGRATH 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	207RC0200X	Critical Care Medicine (Internal Medicine) Physician	14122R	LA
2	207RP1001X	Pulmonary Disease Physician	14122R	LA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1487653804
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STEPHANIE MCGRATH BLAIR MD

Provider Business Mailing Address
First Line	:	211 4TH ST
Second Line	:
City	:	ALEXANDRIA
State	:	LA
Zip	:	71301-8421
Country	:	US
Telephone Number	:	318-769-5283
Fax Number	:	318-769-5213

Provider Business Practice Location Address
First Line	:	211 4TH ST
Second Line	:
City	:	ALEXANDRIA
State	:	LA
Zip	:	71301-8421
Country	:	US
Telephone Number	:	318-769-5283
Fax Number	:	318-769-5213

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

Provider Enumeration Date	:	07/18/2005
Last Update Date	:	03/31/2022

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