Provider Demographics
NPI:1366881575
Name:BLAIR MEDICAL ASSOCIATES
Entity type:Organization
Organization Name:BLAIR MEDICAL ASSOCIATES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:CROFTCHECK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:814-946-1655
Mailing Address - Street 1:1414 9TH AVE
Mailing Address - Street 2:
Mailing Address - City:ALTOONA
Mailing Address - State:PA
Mailing Address - Zip Code:16602-2415
Mailing Address - Country:US
Mailing Address - Phone:814-946-1655
Mailing Address - Fax:814-949-7616
Practice Address - Street 1:620 HOWARD AVE
Practice Address - Street 2:
Practice Address - City:ALTOONA
Practice Address - State:PA
Practice Address - Zip Code:16601-4804
Practice Address - Country:US
Practice Address - Phone:814-947-6980
Practice Address - Fax:814-946-7724
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BLAIR MEDICAL ASSOCIATES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-06-20
Last Update Date:2013-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)Group - Multi-Specialty