Lifebridge Suburban Physician Group Ii Llc
Pediatric Adolescent Medicine
Lifebridge Suburban Physician Group Ii Llc is a Randallstown, Maryland based Pediatric center with medical specialization in
Pediatric Adolescent Medicine. Lifebridge Suburban Physician Group Ii Llc is doing business as
Dr. Jacalyn Blackwell-white.
It is located at
5400 Old Court Rd Ste 300b, Randallstown, Maryland - 21133-5100. They can be contacted on phone at
410-521-7337 and fax number 410-521-7377.
NPI number (Unique professional ID) for Lifebridge Suburban Physician Group Ii Llc is
1194170027 which was assigned by NPPES on 28 Apr, 2016 and it was last updated on 31 Aug, 2021.
Lifebridge Suburban Physician Group Ii Llc specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs.
Complete Profile:
Lifebridge Suburban Physician Group Ii Llc basic information including their official name, gender, specialization, credentials etc. are as mentioned below.
| Specialization : | Pediatrics Adolescent Medicine |
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| Provider Name : | Lifebridge Suburban Physician Group Ii Llc |
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| Other Name : | Dr. Jacalyn Blackwell-white |
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Business Address:
Lifebridge Suburban Physician Group Ii Llc address, contact phone number and fax are as below. Patients can directly walkin to the clinic or can call on the below given phone number for appointment.
| Primary Address : | 5400 Old Court Rd Ste 300b
Randallstown, MD, 21133-5100
United States |
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| Phone Number : | 410-521-7337 |
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| Fax Number : | 410-521-7377 |
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Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). NPI details are as mentioned below.
| NPI Number : | 1194170027 |
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| NPI Entity Type : | Organization |
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| First Enrolment Date : | 28 Apr, 2016 |
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| Last Updated On : | 31 Aug, 2021 |
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Authorized Official Details:
Officially authorized person to contact for any management issues or complaints of this organization are as below. Person's position and contact details are as mentioned below.
| Authorized Official Name : | Mary Wright-sisk |
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| Official Title or Position : | DIRECTOR |
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| Phone Number : | 443-422-9941 |
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Licenses and Specialities:
Physicians/Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Lifebridge Suburban Physician Group Ii Llc are as mentioned. Primary taxonomy code for Lifebridge Suburban Physician Group Ii Llc is
2080A0000X (Pediatrics Adolescent Medicine).
| Taxonomy Code | Speciality | Primary | License No. | State |
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| 2080A0000X | Pediatrics Adolescent Medicine | Yes | | |
Other Practice Locations:
| Practice Address | City, State | Phone Number |
|---|
3527 N ROLLING RD, # 1
BALTIMORE, MD, 21244-2223
United States | BALTIMORE, MD | 410-521-7337 |
Mailing Address:
Mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned business address only.
| Mailing Address : | 3527 N Rolling Rd, # 1
Baltimore, MD, 21244-2223
United States |
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| Phone Number : | 410-521-7337 |
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Business Location:
Patients can refer following map for directions to
Lifebridge Suburban Physician Group Ii Llc practice address. Don't forget to take prior appointment before visiting.
** Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 08 January, 2024.