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Ethan Wade Blackburn, MD
Orthopedic Hand Surgery Physician in Louisville, Kentucky
NPI 1538387360

Ethan Wade Blackburn is a Orthopedic Hand Surgery Physician based in Chicago, KY and is specialized in Hand Surgery. Ethan Wade Blackburn practices in Louisville, KY and has the professional credentials of MD. The NPI Number for Ethan Wade Blackburn is 1538387360 and holds a License No. 45826 (Kentucky).

The current practice location address for Ethan Wade Blackburn is 315 E Broadway Ste 195, Louisville, KY and can be reached out via phone at 502-629-4263 and via fax at 502-629-4282.

Location: 315 E Broadway Ste 195, Louisville, KY, 60677-6351
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1538387360
Provider Name
Ethan Wade Blackburn
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
315 E Broadway Ste 195, Louisville, KY, 60677-6351
Phone Number
502-629-4263
Fax Number
502-629-4282
Provider Enumeration Date
04/24/2007
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
7100250140 05 KY
000000833108 01 KY ANTHEM - LAH
149325 01 KY SIHO
50052189 01 KY PASSPORT
institution
Provider Business Practice Location Address Details
Address
315 E Broadway Ste 195
City
Louisville
State
Kentucky
Zip
40202-3700
Phone Number
502-629-4263
Fax Number
502-629-4282
person
Provider Business Mailing Address Details
Address
315 E Broadway Ste 195
City
Louisville
State
Kentucky
Zip
40202-3700
Phone Number
502-629-4263
Fax Number
502-629-4282
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Orthopedic Surgery
Speciality
-
Taxonomy
207X00000X
License No.
()
Definition
An orthopedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system.
person
Provider's Taxonomy Details 2
Type
Allopathic & Osteopathic Physicians
Classification
Orthopedic Surgery
Speciality
Hand Surgery
Taxonomy
207XS0106X
License No.
01071401B (Indiana)
Definition
An orthopedic surgeon trained in the investigation, preservation and restoration by medical, surgical and rehabilitative means of all structures of the upper extremity directly affecting the form and function of the hand and wrist.
person
Provider's Taxonomy Details 3
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
45826 (Kentucky)
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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