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Contact Information

MICHAEL L BLACKBURN, PA-C
3480 YORKSHIRE MEDICAL PARK
LEXINGTON, KY40509-1886
 Phone: 859-263-5140
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Physician Assistant

363A00000X 97 Physician Assistant
 

Surgical

363AS0400X 97 Physician Assistant
Indicates primary specialty

NPI Profile & details for MICHAEL L BLACKBURN · (Male)

NPI # 1639134679
Status Active
Credentials PA-C (Physician Assistant-Certified)
Entity Individual
Enumeration date 04/20/2006
Last updated 12/31/2019 - About 6 years ago
Sole proprietor 1 No
Identifiers
  • KY License # PA934
  • KY Medicaid 95006094
Hospital affiliation(s)
  • ROCKCASTLE REG HOSPITAL & RESPIRATORY CARE CTR - (Acute Care)
    145 NEWCOMB AVENUE
    MOUNT VERNON, KY 40456
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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