National Provider Identifier Database

JACK C BLACKSTONE JR, MD – NPI #1912994583
Gynecology

A physician who specializes in diagnosis, treatment, and management of patients with gynecologic conditions.


Contact Information

JACK C BLACKSTONE JR, MD
1000 BRECKENRIDGE ST
SUITE 200
OWENSBORO, KY42303-0839
Phone: 270-926-3700
Fax: 270-926-2114
Website:
Specialty Taxonomy Code
* Gynecology 207VG0400X

* Indicates primary specialty

NPI Profile & details for JACK C BLACKSTONE JR

NPI Number 1912994583
Credentials MD
Entity Individual
Enumeration date 09/29/2005
Last updated 07/08/2010 - About 16 years ago
Sole proprietor1 No
Identifiers
  • KY License #: 18142
  • KY Medicaid: 64181423
Hospital affiliation n/a

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.

Reviews for JACK C BLACKSTONE JR, MD

There are currently no reviews for JACK C BLACKSTONE JR, MD


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