Provider Demographics
NPI:1619344223
Name:BLAIR, ELIZABETH (PA-C)
Entity type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:
Last Name:BLAIR
Suffix:
Gender:
Credentials:PA-C
Other - Prefix:
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Mailing Address - Street 1:3025 SHRINE RD STE 290
Mailing Address - Street 2:
Mailing Address - City:BRUNSWICK
Mailing Address - State:GA
Mailing Address - Zip Code:31520-4785
Mailing Address - Country:US
Mailing Address - Phone:912-466-7660
Mailing Address - Fax:912-264-1526
Practice Address - Street 1:3025 SHRINE RD STE 290
Practice Address - Street 2:
Practice Address - City:BRUNSWICK
Practice Address - State:GA
Practice Address - Zip Code:31520-4785
Practice Address - Country:US
Practice Address - Phone:912-466-7660
Practice Address - Fax:912-264-1526
Is Sole Proprietor?:No
Enumeration Date:2015-08-31
Last Update Date:2025-03-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA3744363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical