Individual
LISA R BLACKRICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3627 UNIVERSITY BLVD S STE 550, JACKSONVILLE, FL 32216-7401
(904) 379-5986
(904) 551-0282
Mailing address
PO BOX 370, FORTSON, GA 31808-0370
(706) 494-3008
Taxonomy
Speciality
Code
Description
License number
State
207XX0801X
Orthopaedic Trauma Physician
Primary
ME144788
FL
Other
Enumeration date
06/05/2007
Last updated
09/14/2020
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