Healthcare Provider Details

I. General information

NPI: 1407846868
Provider Name (Legal Business Name): BRIAN HEATH BLAIR MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/26/2005
Last Update Date: 10/07/2025
Certification Date: 10/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2263 HWY 65 N
MARSHALL AR
72650-1266
US

IV. Provider business mailing address

4196 HIGHWAY 62 412 STE A
HARDY AR
72542-8002
US

V. Phone/Fax

Practice location:
  • Phone: 870-448-5733
  • Fax: 870-448-3392
Mailing address:
  • Phone: 870-856-2100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberE2463
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: