Provider Demographics
NPI:1235926924
Name:BLACKSTOCK, SARAH ANN (MD)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:ANN
Last Name:BLACKSTOCK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:116 MONTCREST PT
Mailing Address - Street 2:
Mailing Address - City:GADSDEN
Mailing Address - State:AL
Mailing Address - Zip Code:35901-6408
Mailing Address - Country:US
Mailing Address - Phone:256-458-5134
Mailing Address - Fax:
Practice Address - Street 1:833 PRINCETON AVE SW
Practice Address - Street 2:POB III, SUITE 200E
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35211
Practice Address - Country:US
Practice Address - Phone:205-599-4822
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-24
Last Update Date:2025-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program