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General NPI Number Information
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NPI Number | 1598802340
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Entity Type | Individual
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Provider Name | BLAIR JOHN LAMEY OD
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Gender | Male
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Dates
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Enumeration Date | 01/31/2007
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Last Update Date | 01/10/2022
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Provider Practice Location Address
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Address Line | 2400 MOUNT ZION PKWY KAISER PERMANENTE SOUTHWOOD MEDICAL CENTER
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City | JONESBORO
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State | GA
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Zip | 30236-2500
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Country | US
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Telephone | 423-899-2905
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Fax | 423-894-3261
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Provider Business Mailing Address
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Address Line | 3495 PIEDMONT RD NE NINE PIEDMONT CENTER
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City | ATLANTA
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State | GA
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Zip | 30305-1717
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Country | US
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Telephone | 404-364-7070
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | ODT2368
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OPT002027
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License Number State | GA
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