Provider Demographics
NPI:1376670828
Name:BIDDLE, ROBERT ALLEN (MD)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:ALLEN
Last Name:BIDDLE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:BOB
Other - Middle Name:
Other - Last Name:BIDDLE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:4888 LEXINGTON ROAD
Mailing Address - Street 2:
Mailing Address - City:PARIS
Mailing Address - State:KY
Mailing Address - Zip Code:40361
Mailing Address - Country:US
Mailing Address - Phone:859-988-0100
Mailing Address - Fax:859-988-0086
Practice Address - Street 1:4888 LEXINGTON RD
Practice Address - Street 2:
Practice Address - City:PARIS
Practice Address - State:KY
Practice Address - Zip Code:40361
Practice Address - Country:US
Practice Address - Phone:859-988-0100
Practice Address - Fax:859-988-0086
Is Sole Proprietor?:No
Enumeration Date:2007-02-28
Last Update Date:2014-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY17524207P00000X, 207Q00000X
MT8495207P00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64175243Medicaid
C73979Medicare UPIN