Individual provider · Type 1 NPI
Glenn Koontz Blackburn Jr., MD
Pediatric Adolescent Medicine Physician · Somerset, KY
NPI number
1750351037
Active
Practice location
Children's Clinic, 350 Langdon St.
Somerset, KY 42503
Fax (606) 678-7548
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Pediatric Adolescent Medicine Physician Primary | 2080A0000X | 16207 (KY) |
Pediatric Adolescent Medicine Physician: A pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs.
About NPI 1750351037
Glenn Koontz Blackburn Jr., MD's National Provider Identifier is 1750351037, issued on Jan 26, 2006. The primary taxonomy on file is Pediatric Adolescent Medicine Physician (2080A0000X), and the practice location is in Somerset, KY. The record was last updated on Jul 13, 2026.