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General NPI Number Information
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NPI Number | 1831036995
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Entity Type | Organization
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Legal Business Name | THE SKIN INSTITUTE PLLC
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Dates
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Enumeration Date | 04/29/2026
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Last Update Date | 04/29/2026
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Provider Practice Location Address
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Address Line | 127 ALBEN BARKLEY DR
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City | PADUCAH
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State | KY
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Zip | 42001-4402
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Country | US
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Telephone | 270-444-8477
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Fax | 270-228-4141
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Provider Business Mailing Address
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Address Line | 127 ALBEN BARKLEY DR
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City | PADUCAH
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State | KY
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Zip | 42001-4402
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Country | US
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Telephone | 270-444-8477
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Fax | 270-228-4141
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Authorized Official
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Title or Position | OWNER
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Name | JOSEPH ALLEN BLACKMON
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Credential | MD
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Telephone | 270-444-8477
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number |
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License Number State |
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