Provider Demographics
NPI:1780606236
Name:BLAIR, JOHN RODNEY (MD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:RODNEY
Last Name:BLAIR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2275 S OCEAN BLVD
Mailing Address - Street 2:#201-N
Mailing Address - City:PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33480-5356
Mailing Address - Country:US
Mailing Address - Phone:561-585-2603
Mailing Address - Fax:561-582-8817
Practice Address - Street 1:14147 US HIGHWAY 1
Practice Address - Street 2:
Practice Address - City:JUNO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33408-1427
Practice Address - Country:US
Practice Address - Phone:561-694-2229
Practice Address - Fax:561-694-1338
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME74889207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
BO3560Medicare UPIN
46383Medicare ID - Type Unspecified