Individual
DR. BLAKE BRICKEY JACKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
8901 CARTI WAY, LITTLE ROCK, AR 72205-6523
(501) 906-3000
(501) 907-6522
Mailing address
PO BOX 55050, LITTLE ROCK, AR 72215-5050
(501) 906-0000
(501) 907-6522
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
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—
Other
Enumeration date
03/31/2015
Last updated
09/28/2022
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