NPI 1750351037 · live from the CMS NPI Registry
Glenn Koontz Blackburn, M.D.
Pediatrics, Adolescent Medicine in Somerset, KY. National Provider Identifier 1750351037, active.
NPI record
| NPI | 1750351037 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Pediatrics, Adolescent Medicine 2080A0000X |
| Practice location | Children'S Clinic, 350 Langdon St., Somerset, KY 42503 |
| Practice phone | 606-678-8155 |
| Enumerated | January 26, 2006 |
| Last updated | July 13, 2026 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Pediatrics, Adolescent Medicine primary | 2080A0000X | 16207 (KY) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.