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General NPI Number Information
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NPI Number | 1235595364
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Entity Type | Organization
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Legal Business Name | JC BLAIR MEDICAL SERVICES INC.
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Dates
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Enumeration Date | 01/05/2016
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Last Update Date | 01/30/2019
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Provider Practice Location Address
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Address Line | 820 BRYAN ST SUITE 1
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City | HUNTINGDON
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State | PA
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Zip | 16652-2409
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Country | US
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Telephone | 814-643-0837
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Fax | 814-643-8272
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Provider Business Mailing Address
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Address Line | 1225 WARM SPRINGS AVE
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City | HUNTINGDON
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State | PA
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Zip | 16652-2350
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Country | US
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Telephone | 814-643-7082
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Fax | 814-643-8334
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Authorized Official
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Title or Position | CFO
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Name | JOSEPH MYERS
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Credential |
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Telephone | 814-643-2290
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number | 101101
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License Number State | PA
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