DR. JACK C BLACKSTONE JR. M.D. NPI 1912994583

NPI Information

  • NPI: 1912994583
  • Provider Name: DR. JACK C BLACKSTONE, JR., M.D.
  • Classification: Obstetrics & Gynecology - 207VG0400X
  • Specialization: Gynecology
  • Entity Type: Individual
  • Address: 1000 BRECKENRIDGE ST
    SUITE 200
    OWENSBORO, KY
    ZIP 42303
  • Phone: (270) 926-3700

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NPI Details

DR. Jack C Blackstone, Jr., M.D. is a gynecology obstetrics gynecology in Owensboro, KY. The provider is a physician who specializes in diagnosis, treatment, and management of patients with gynecologic conditions. Source: National Uniform Claim Committee DR. Jack C Blackstone, Jr., M.D. NPI is 1912994583. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1000 BRECKENRIDGE ST
SUITE 200
OWENSBORO, KY
ZIP 42303-839
Phone: (270) 926-3700
Fax: (270) 926-2114

The enumeration date for this NPI number is 9/29/2005 and was last updated on 7/8/2010.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207VG0400XObstetrics & GynecologyGynecology18142KENTUCKYYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1D32272MEDICARE UPINKENTUCKY
264181423MEDICAIDKENTUCKY
30504402MEDICARE ID-TYPE UNSPECIFIEDKENTUCKY

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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