Healthcare Provider Details

I. General information

NPI: 1558342352
Provider Name (Legal Business Name): FIONA A BLAIR M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/09/2005
Last Update Date: 06/25/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2240 W. PARK PL BLVD SUITE A
STONE MOUNTAIN GA
30087
US

IV. Provider business mailing address

2240 W. PARK PL BLVD SUITE A
STONE MOUNTAIN GA
30087
US

V. Phone/Fax

Practice location:
  • Phone: 770-771-5222
  • Fax: 770-771-5223
Mailing address:
  • Phone: 770-771-5222
  • Fax: 770-771-5223

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number041729
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number41729
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: