Lifebridge Suburban Physician Group II LLC
Lifebridge Suburban Physician Group II LLC is a Pediatric Adolescent Medicine Physician in Randallstown, Maryland. Works from 2 locations. Registered with an NPI since 2016.
- In the registry since
- 2016
What do these letters mean?
- LLC — Limited liability company
- A form of business registration, not a clinical qualification.
Practice location Address checks out
5400 Old Court Rd Ste 300BRandallstown, MD 21133-5100
Phone: (410) 521-7337
Fax: (410) 521-7377
Show map & directions
Directions in Google Maps · Apple Maps · OpenStreetMap
Pin is approximate — placed at the ZIP-code centre, not the exact door.
Additional practice locations (1)
- 3527 N Rolling Rd, Baltimore, MD 21244-2223 — (410) 521-7337
Specialties & licences
| Pediatric Adolescent Medicine Physician (primary) | Taxonomy 2080A0000X |
|---|
Record details
| NPI number | 1194170027 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | Yes |
| Parent organization | Lifebridge Community Physicians, Inc |
| Authorized official | Mary Wright-Sisk — Director · (443) 422-9941 |
| Other names | Dr. Jacalyn Blackwell-White; Dr. Jacalyn Blackwell-White |
| NPI enumerated | April 28, 2016 |
| Last updated in NPPES | August 31, 2021 |
| Certification date | August 31, 2021 |
| Mailing address | 3527 N Rolling Rd, 1, Baltimore, MD 21244-2223 |
Other providers in Randallstown
-
Dr. Jacalyn Cecelia Blackwell-White, MD
5400 Old Court Rd Ste 300B, Randallstown, MD 21133-5100 · (410) 521-7337