Individual
LISA CHRISTINE BLACKLOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
DEPARTMENT OF RADIOLOGY, 1 UNIVERSITY OF NEW MEXICO MSC10 5530, ALBUQUERQUE, NM 87131-0001
(505) 272-2269
Mailing address
800 BRADBURY DR SE STE 116, ALBUQUERQUE, NM 87106-4310
(505) 272-1476
Taxonomy
Speciality
Code
Description
License number
State
2085N0904X
Nuclear Radiology Physician
Primary
MZ2011-0401
NM
2085R0202X
Diagnostic Radiology Physician
MZ2011-0401
NM
Other
Enumeration date
06/28/2008
Last updated
01/13/2025
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