Basic Information
| Provider Information | |||||||||
| NPI: | 1811573702 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BARTLETT | ||||||||
| FirstName: | BLAIR | ||||||||
| MiddleName: | ASHLEY | ||||||||
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| Credential: | FNP-BC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2805 HAMILTON MILL RD | ||||||||
| Address2: | |||||||||
| City: | BUFORD | ||||||||
| State: | GA | ||||||||
| PostalCode: | 305194110 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6785410588 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2805 HAMILTON MILL RD | ||||||||
| Address2: | |||||||||
| City: | BUFORD | ||||||||
| State: | GA | ||||||||
| PostalCode: | 305194110 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6785410588 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/22/2021 | ||||||||
| LastUpdateDate: | 03/22/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 03/22/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | RN259538 | GA | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.