MAES EARL BLAIR III
Debarred entityBorn 27 Jan 1972 (54 years old),United States. Named in 5 sanctions listings.
Summary
KMAP Provider Number 30004512440003
Sanctions and listings5
- Effective
- 18 Dec 2025
List of Excluded Individuals/Entities (LEIE)
Department of Health and Human Services Office of Inspector GeneralUS Health and Human Services Inspector General ExclusionsUnited States
1128a1
Programme US-HHS-OIGoig.hhs.govoig.hhs.gov
- Effective
- 18 Dec 2025
Official designation
New York State Office of the Medicaid Inspector GeneralUS New York State Medicaid ExclusionsUnited States
- Effective
- 6 Feb 2026
Official designation
Missouri Medicaid Audit & ComplianceUS Missouri Medicaid Provider TerminationsUnited States
CRIMINAL CONVICTION
- Effective
- 18 Dec 2025
Official designation
New Jersey Office of the State ComptrollerUS New Jersey Ineligible Medicaid ProvidersUnited States
DISQUALIFICATION
- Effective
- 18 Dec 2025
Official designation
Kansas Department of Health and EnvironmentUS Kansas Medicaid Terminated Provider ListUnited States
HHS-OIG excluded participation.
Positions held1
Period not retained
RADIOLOGY (PHYSICIAN (MD, DO))
Identifiers2
| Identifier | Number |
|---|---|
| ID number | 00254800 |
| NPI number | 1699717363 |
Other names4
Also known as4
Addresses2
1249 E MONTCLAIR ST, SPRINGFIELD, MO 65804
1249 E. MONTCLAIR STREET, SPRINGFIELD, MO 65804
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