Provider Demographics
NPI:1598865677
Name:BURGETT, ROBERT BEN (DO)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:BEN
Last Name:BURGETT
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 432
Mailing Address - Street 2:
Mailing Address - City:PIKEVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:41502-0432
Mailing Address - Country:US
Mailing Address - Phone:606-218-3985
Mailing Address - Fax:
Practice Address - Street 1:23 WILLOW DR
Practice Address - Street 2:
Practice Address - City:AUXIER
Practice Address - State:KY
Practice Address - Zip Code:41602-9259
Practice Address - Country:US
Practice Address - Phone:606-886-8997
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2023-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY04475207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY85001683Medicaid
KY85001683Medicaid
KYU85314Medicare UPIN