Provider Demographics
NPI:1487546636
Name:BLAIR SMART , MD APC
Entity type:Organization
Organization Name:BLAIR SMART , MD APC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:BLAIR
Authorized Official - Middle Name:
Authorized Official - Last Name:SMART
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:989-878-0093
Mailing Address - Street 1:4322 GARDEN HOMES AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90032-1110
Mailing Address - Country:US
Mailing Address - Phone:989-878-0093
Mailing Address - Fax:
Practice Address - Street 1:4322 GARDEN HOMES AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90032-1110
Practice Address - Country:US
Practice Address - Phone:989-878-0093
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-21
Last Update Date:2025-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty