Amanda J. Blackburn in Jackson - Physician Assistant
Amanda J. Blackburn - NPI 1912994260
Amanda J. Blackburn is a Physician Assistant in Jackson, Kentucky. Amanda J. Blackburn practices all healthcare services and medical treatments related to Physician Assistant. The NPI Number for Amanda J. Blackburn is 1912994260. The last update date is 2022-05-19.
Amanda J. Blackburn's current location address is 1484 Lakeside Dr, Jackson, Kentucky. You can contact this provider via phone number 6066669950 and fax number 6066669136. The mailing address for Amanda J. Blackburn is 1484 Lakeside Dr, Jackson, Kentucky. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Amanda J. Blackburn |
|---|---|
| Address | 1484 Lakeside Dr, Jackson, Kentucky |
| Phone Number | 6066669950 |
| Fax Number | 6066669136 |
| Sole Proprietor | N |
| Credentials | PA-C |
NPI Number Detail
| NPI Number | 1912994260 |
|---|---|
| Provider Enumeration Date | 2005-10-03 |
| Last Updated Date | 2022-05-19 |
Provider Mailing Address Detail
| Address | 1484 Lakeside Dr |
|---|---|
| City | Jackson |
| State | Kentucky (KY) |
| Post Code | 413396555 |
| Phone Number | 6066669950 |
| Fax Number | 6066669136 |
Provider's Primary Taxonomy Detail
| Speciality | Physician Assistant |
|---|---|
| Taxonomy | 363A00000X |
| Licence No | PA804 |
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Definition: A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perfor |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 950041230 | KY | -- |
Post Comment/ Review Below
What is the unique identification code assigned to Amanda J. Blackburn by the Centers for Medicare & Medicaid Services?
The Amanda J. Blackburn has been issued the NPI (National Provider Identifier) 1912994260. This 10-digit code serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Could you provide the complete address where Amanda J. Blackburn is physically located?
The Amanda J. Blackburn is situated at the following address: 1484 Lakeside Dr, Jackson, KY 413396555.
What is Amanda J. Blackburn's primary area of medical expertise, and what taxonomy classification code corresponds to this specialized field?
The primary area of medical expertise for Amanda J. Blackburn is Physician Assistant, and the corresponding taxonomy classification code for this specialized field is 363A00000X.
On what date was the 1912994260 assigned to Amanda J. Blackburn?
The Amanda J. Blackburn was issued its 1912994260 on 2005-10-03, which is the date when this unique identifier was assigned to the organization by the Centers for Medicare & Medicaid Services.
As of what date were the details pertaining to Amanda J. Blackburn last refreshed?
The information related to the Amanda J. Blackburn, including its address, specialty, and other relevant details, was last updated on 2022-05-19.