Dr. Glenn Koontz Blackburn Jr., MD

Individual provider Pediatric Adolescent Medicine Physician · NPI 1750351037

Dr. Glenn Koontz Blackburn Jr., MD is a Pediatric Adolescent Medicine Physician in Somerset, Kentucky. Licensed in Kentucky. Registered with an NPI since 2006.

Licensed in: KY
In the registry since: 2006

What do these letters mean?

MD — Doctor of Medicine: A physician who completed allopathic medical school.

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Practice location Partly verified

Some contact details are missing from the federal record.

Children's Clinic 350 Langdon St
Somerset, KY 42503
Phone: (606) 678-8155
Fax: (606) 678-7548

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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pediatric Adolescent Medicine Physician (primary)	Taxonomy 2080A0000X · Licence 16207 (KY)

Record details

NPI number	1750351037
Entity type	Individual (Type 1)
Gender	Male
Credentials	MD
Sole proprietor	No
NPI enumerated	January 26, 2006
Last updated in NPPES	July 13, 2026