National Provider Identifier Database

MADELINE W BLACKWELL, PA-C – NPI #1053046946
Surgical


Contact Information

MADELINE W BLACKWELL, PA-C
2601 KENTUCKY AVE STE 201
PADUCAH, KY42003-3825
Phone: 270-538-9555
Fax: 270-538-9554
Website:
Specialty Taxonomy Code
* Surgical 363AS0400X
Student in an Organized Health Care Education/Training Program 390200000X

* Indicates primary specialty

NPI Profile & details for MADELINE W BLACKWELL

NPI Number 1053046946
Credentials PA-C (Physician Assistant-Certified)
Entity Individual
Enumeration date 07/23/2022
Last updated 01/12/2026 - About 5 months ago
Sole proprietor1 No
Identifiers
  • KY Medicaid: 7100933030
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.

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