Provider Demographics
NPI:1487847331
Name:HERBST, ROBERT JAMEY (DPM)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:JAMEY
Last Name:HERBST
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:600 MEIJER DR STE 104
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:KY
Mailing Address - Zip Code:41042-4878
Mailing Address - Country:US
Mailing Address - Phone:859-757-8262
Mailing Address - Fax:859-282-1086
Practice Address - Street 1:600 MEIJER DR STE 104
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:KY
Practice Address - Zip Code:41042-4878
Practice Address - Country:US
Practice Address - Phone:859-757-8262
Practice Address - Fax:859-282-1086
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-23
Last Update Date:2021-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN07000975A213E00000X
KY00353213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist