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NPI Lookup from the NPI Registry — National Provider Identifier Database

ETHAN W BLACKBURN, MD – NPI #1538387360
Hand Surgery

An orthopaedic surgeon trained in the investigation, preservation and restoration by medical, surgical and rehabilitative means of all structures of the upper extremity directly affecting the form and function of the hand and wrist.


Contact Information

ETHAN W BLACKBURN, MD
315 E BROADWAY STE 195
LOUISVILLE, KY40202-3700
 Phone: 502-629-4263
 Fax: 502-629-4282
 Website:
 

Taxonomy / Specialty

Taxonomy Code

Hand Surgery

207XS0106X
 

Orthopaedic Surgery

207X00000X
 

Student in an Organized Health Care Education/Training Program

390200000X
Indicates primary specialty
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NPI Information for ETHAN W BLACKBURN · (Male)

NPI Number 1538387360
Credentials MD
Entity Individual
Enumeration date 04/24/2007
Last updated 09/25/2014 - About 3 months ago
Sole proprietor 1 No
Identifiers
IN License # 01071401B
KY License # 45826
KY Medicaid 7100250140
IN Medicare PIN M400074734
KY Medicare PIN K103330
KY Other 000000833108 ANTHEM - LAH
KY Other 50052189 PASSPORT
KY Other 149325 SIHO
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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