Provider Demographics
NPI:1982668752
Name:BLAIR, JOHN B (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:B
Last Name:BLAIR
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Gender:M
Credentials:MD
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Mailing Address - Street 1:400 BLANKENBAKER PKWY
Mailing Address - Street 2:SUITE 200
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40243-1882
Mailing Address - Country:US
Mailing Address - Phone:502-244-6373
Mailing Address - Fax:502-244-9860
Practice Address - Street 1:400 BLANKENBAKER PKWY
Practice Address - Street 2:SUITE 200
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40243-1882
Practice Address - Country:US
Practice Address - Phone:502-244-6373
Practice Address - Fax:502-244-9860
Is Sole Proprietor?:No
Enumeration Date:2006-04-17
Last Update Date:2021-07-12
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Provider Licenses
StateLicense IDTaxonomies
KY35793208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
KYH68363Medicare UPIN