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General NPI Number Information
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NPI Number | 1821199647
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Entity Type | Individual
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Provider Name | PAUL ALEX BLAIR M.D.
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Gender | Male
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Dates
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Enumeration Date | 09/26/2006
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Last Update Date | 12/03/2007
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Provider Practice Location Address
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Address Line | 3667 TEAYS VALLEY RD
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City | HURRICANE
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State | WV
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Zip | 25526-9658
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Country | US
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Telephone | 304-201-3223
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Fax | 304-201-6555
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Provider Business Mailing Address
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Address Line | 3667 TEAYS VALLEY RD
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City | HURRICANE
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State | WV
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Zip | 25526-9658
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Country | US
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Telephone | 304-201-3223
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Fax | 304-201-6555
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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 | 207YS0123X
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Taxonomy Name | Facial Plastic Surgery Physician
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License Number | 11537
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License Number State | WV
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