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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 Specialty Code Provider Type

Surgical

363AS0400X 97 Physician Assistant
 

Student in an Organized Health Care Education/Training Program

390200000X
Indicates primary specialty

NPI Profile & details for MADELINE W BLACKWELL · (Female)

NPI # 1053046946
Status Active
Credentials PA-C (Physician Assistant-Certified)
Entity Individual
Enumeration date 07/23/2022
Last updated 01/12/2026 - About 5 months ago
Sole proprietor 1 No
Identifiers
  • KY Medicaid 7100933030
Hospital affiliation(s) Not Available
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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