Provider Demographics
NPI:1649240474
Name:BINFORD, ROBERT BAILEY (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:BAILEY
Last Name:BINFORD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:R.
Other - Middle Name:BAILEY
Other - Last Name:BINFORD
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:95 MAPLEHURST LN
Mailing Address - Street 2:
Mailing Address - City:MURRAY
Mailing Address - State:KY
Mailing Address - Zip Code:42071-5413
Mailing Address - Country:US
Mailing Address - Phone:270-436-2484
Mailing Address - Fax:
Practice Address - Street 1:95 MAPLEHURST LN
Practice Address - Street 2:
Practice Address - City:MURRAY
Practice Address - State:KY
Practice Address - Zip Code:42071-5413
Practice Address - Country:US
Practice Address - Phone:270-436-2484
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-24
Last Update Date:2017-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY139972084P0800X
TN00000051022084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN00004120OtherBCBS OF TN PIN
KY12087882OtherRAILROAD MEDICARE PTAN (INDIVIDUAL PROVIDER)
KY64139975Medicaid
KY000000258421OtherANTHEM PROVIDER PIN
12087882Medicare PIN
KY000000258421OtherANTHEM PROVIDER PIN
KYA99486Medicare UPIN
KY00931006Medicare PIN
KY1222001Medicare PIN
TN00004120OtherBCBS OF TN PIN
KY65927394OtherLOURDES PHYSICIAN SERVICES MEDICAID GROUP #
TNBB7668532OtherDEA #
KY1222001Medicare PIN