Healthcare Provider Details

I. General information

NPI: 1851688923
Provider Name (Legal Business Name): SCOTT BLAIR D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/08/2011
Last Update Date: 11/15/2021
Certification Date: 11/15/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2451 FILLINGIM ST RM 709
MOBILE AL
36617-2238
US

IV. Provider business mailing address

800 STANTON L YOUNG BLVD STE 9000
OKLAHOMA CITY OK
73104-5018
US

V. Phone/Fax

Practice location:
  • Phone: 251-533-8805
  • Fax:
Mailing address:
  • Phone: 251-533-8805
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0127X
TaxonomyTrauma Surgery Physician
License Number6366
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: