Paul Thomas Blair, OTR/L
Individual provider Active NPI Occupational Therapist · Dyer, TN
NPI 1104445659 · NPPES record last updated Apr 14, 2020
Key facts
- NPI
- 1104445659
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Occupational Therapist 225X00000X
- License
- OT502 (TN)
- Practice address
- 322 E College St
Dyer, TN 38330-1730 - Phone
- (731) 420-0446
- NPI assigned
- Apr 14, 2020
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OT502 | TN | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ut Lebonheur Pediatric Specialists, Inc. | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | OT502 | TN | Yes |
Addresses
Primary practice location
322 E College St
Dyer, TN 38330-1730
Mailing address
11830 Highway 70
Cedar Grove, TN 38321-6456
Phone (731) 420-0446
Other practice location 1
811 S College St
Trenton, TN 38382-2801
Phone (731) 420-0446
Other providers in Dyer, TN
- Stephen Baird
- Lauren S Blackwood
- Gary James Buchanan
- Jamie Burrus
- Jenna Lee Dubruiel
- Douglas R Duncan
- Dyer Nursing Home, Inc.
All providers in Dyer, TN · Occupational Therapist in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 14, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.