Amanda Suson Blair, D.P.T,
Individual provider Active NPI Military Health Care Provider · Marshall, AR
NPI 1295986388 · NPPES record last updated Oct 7, 2008
Key facts
- NPI
- 1295986388
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Military Health Care Provider 171000000X
- License
- PT 3102 (AR)
- Practice address
- 1458 Hensley Farm Rd
Marshall, AR 72650-8672 - Phone
- (870) 448-6232
- NPI assigned
- Oct 7, 2008
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|
| PT 3102 | AR | MD | Military Health Care Provider |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Military Health Care Provider | 171000000X | PT 3102 | AR | Yes |
Addresses
Primary practice location
1458 Hensley Farm Rd
Marshall, AR 72650-8672
Mailing address
1458 Hensley Farm Rd
Marshall, AR 72650-8672
Phone (870) 448-6232
Other providers in Marshall, AR
- Arkansas Home Medical, Inc.
- Thomas Burton Bailey
- Jennifer Loy Baker
- Leah Suzanne Beck
- Shannon Black
- Brian Heath Blair
- Boston Mountain Rural Health Center Inc
- Boston Mountain Rural Health Center Inc
- Boston Mountain Rural Health Center, Inc
- Rhonda Elaine Brock
All providers in Marshall, AR · Military Health Care Provider in Arkansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 7, 2008. 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.