Provider Demographics
NPI:1629517347
Name:BLAIR, ANTHONY RAY (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:RAY
Last Name:BLAIR
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:605 HIGHWAY 51 N
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:TN
Mailing Address - Zip Code:38019-2034
Mailing Address - Country:US
Mailing Address - Phone:901-475-2157
Mailing Address - Fax:901-475-4699
Practice Address - Street 1:605 HIGHWAY 51 N
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:TN
Practice Address - Zip Code:38019-2034
Practice Address - Country:US
Practice Address - Phone:901-475-2157
Practice Address - Fax:901-475-4699
Is Sole Proprietor?:No
Enumeration Date:2017-02-14
Last Update Date:2017-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000040688183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist