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Individual
DR. BLAKE BRICKEY JACKS
Active
Individual
DR. BLAKE BRICKEY JACKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
E-12730
AR
2085R0202X
Diagnostic Radiology Physician
ME142675
FL
2085R0204X
Vascular & Interventional Radiology Physician
Primary
E-12730
AR
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/31/2015
Last updated
09/28/2022
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