Provider Demographics
NPI:1619264371
Name:FLOWERS, ROBERT LYNN JR (DO)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:LYNN
Last Name:FLOWERS
Suffix:JR
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 277
Mailing Address - Street 2:
Mailing Address - City:BURKESVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:42717-0277
Mailing Address - Country:US
Mailing Address - Phone:270-864-3371
Mailing Address - Fax:270-864-5667
Practice Address - Street 1:333 KEEN ST
Practice Address - Street 2:
Practice Address - City:BURKESVILLE
Practice Address - State:KY
Practice Address - Zip Code:42717-7682
Practice Address - Country:US
Practice Address - Phone:270-864-3371
Practice Address - Fax:270-864-5667
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-01
Last Update Date:2015-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYTP928208D00000X
VA0116023740207R00000X
KY03744207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY00544666OtherANTHEM BCBS MEDICAID
KY7100324340Medicaid
KY1052425OtherWELLCARE MEDICAID
KY000000887212OtherANTHEM BCBS
KY00544666OtherANTHEM BCBS MEDICAID