Provider Demographics
NPI:1518950302
Name:ROMINES, ROBERT BURNS (MD)
Entity type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:BURNS
Last Name:ROMINES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:325 E BROADWAY ST
Mailing Address - Street 2:
Mailing Address - City:CAMPBELLSVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:42718-2003
Mailing Address - Country:US
Mailing Address - Phone:270-937-9030
Mailing Address - Fax:270-789-4664
Practice Address - Street 1:325 E BROADWAY ST
Practice Address - Street 2:
Practice Address - City:CAMPBELLSVILLE
Practice Address - State:KY
Practice Address - Zip Code:42718-2003
Practice Address - Country:US
Practice Address - Phone:270-937-9030
Practice Address - Fax:270-789-4664
Is Sole Proprietor?:No
Enumeration Date:2005-08-26
Last Update Date:2025-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL00014180208600000X
KY28637208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY1700387OtherUNITED HEALTH CARE
KY000000051158OtherANTHEM BC/BS
KY020026449OtherRR MEDICARE
KY64286370Medicaid
C70974Medicare UPIN
KY64286370Medicaid
KY000000051158OtherANTHEM BC/BS