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NPI Code Detail

MEDICARE: LEO BLAIR

MEDICARE: LEO BLAIR
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1246Z00000XOther Specialist/Technologist

General Provider Information

NPI Number : 1427911999
Entity Type Code : Individual
Provider Name (Legal Business Name) : LEO BLAIR
Provider Business Mailing Address
First Line : 2007 OSSABAW DR
Second Line :
City : HINESVILLE
State : GA
Zip : 31313-9496
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1061 HARMON AVE
Second Line :
City : FORT STEWART
State : GA
Zip : 31314-5641
Country : US
Telephone Number : 571-802-0394
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/03/2025
Last Update Date : 12/03/2025

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Directions to “ LEO BLAIR ” Practice Location

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