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Jerry R Blair, M.D., Ph.D.

Ophthalmology in Columbia, MO. Individual provider (NPI-1).

NPI number1790769701
StatusActive
Last updated in NPPESApr 10, 2017

Details

NPI
1790769701
Entity type
Individual (NPI-1)
Name
Jerry R Blair
Credential
M.D., Ph.D.
Sex
Male
Sole proprietor
No
Enumeration date
Dec 2, 2005
Last updated
Apr 10, 2017

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207W00000X Ophthalmology108058MOYes
207WX0107X Ophthalmology, Retina Specialist108058MO

Practice location

3600 Amron Ct
Columbia, MO 65202-1918

Phone 573-874-1616 · Fax 573-875-0300

Mailing address

3600 Amron Ct
Columbia, MO 65202-1918

Phone 573-874-1616 · Fax 573-875-0300

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