Individual
JOHN W BLACKBURN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
911 BYPASS RD BLDG A, PIKEVILLE, KY 41501-1689
(606) 430-3500
(606) 437-1033
Mailing address
PO BOX 432, PIKEVILLE, KY 41502-0432
(606) 430-3500
(606) 437-1033
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
4204
GA
207L00000X
Anesthesiology Physician
Primary
48968
KY
207LC0200X
Critical Care Medicine (Anesthesiology) Physician
072985
GA
207LP2900X
Pain Medicine (Anesthesiology) Physician
31227
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100406930
—
KY
Enumeration date
06/22/2010
Last updated
10/05/2022
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