Individual
DR. LAVERNE RUTH BLACKWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1100 N COLLEGE AVE, FAYETTEVILLE, AR 72703-1944
(479) 443-4301
Mailing address
1100 N COLLEGE AVE, FAYETTEVILLE, AR 72703-1944
(479) 443-4301
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
21827
AZ
2085R0202X
Diagnostic Radiology Physician
A40527
CA
Other
Enumeration date
07/28/2006
Last updated
09/11/2025
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