Provider Demographics
NPI:1801866637
Name:R. BAILEY BINFORD MD, PLLC
Entity Type:Organization
Organization Name:R. BAILEY BINFORD MD, PLLC
Other - Org Name:R BAILEY BINFORD PSC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:SOLE MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:BAILEY
Authorized Official - Last Name:BINFORD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:270-753-7272
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:270-753-7272
Mailing Address - Fax:270-436-2803
Practice Address - Street 1:312 S 8TH ST
Practice Address - Street 2:
Practice Address - City:MURRAY
Practice Address - State:KY
Practice Address - Zip Code:42071-2428
Practice Address - Country:US
Practice Address - Phone:270-753-7272
Practice Address - Fax:270-436-2803
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-24
Last Update Date:2009-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY22000000057826OtherANTHEM GROUP #
KY64139975Medicaid