Blackburn, Michael Lowell

Blackburn, Michael Lowell is an individual health care provider with primary practice located at 3480 Yorkshire Medical Park , Lexington KY 40509-1886. He recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Surgical, Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant. Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant is his primary health care specialty. Blackburn, Michael Lowell can be contacted via phone (859) 263-5140.

Contact Information

Primary practice address
3480 Yorkshire Medical Park Lexington KY 40509-1886
Phone: (859) 263-5140
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X PA934 Kentucky
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA934 Kentucky

Profile Details

NPI number 1639134679
LBN Legal business name Blackburn, Michael Lowell
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 20th, 2006
Last updated Dec 31st, 2019 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1639134679 NPPES
Kentucky MEDICAID 95006094

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