Provider Demographics
NPI:1982877098
Name:ROBERT B BUX MD FACS PLLC
Entity Type:Organization
Organization Name:ROBERT B BUX MD FACS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:BRENTWOOD
Authorized Official - Last Name:BUX
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:606-864-2541
Mailing Address - Street 1:1114 REUBEN ST
Mailing Address - Street 2:SUITE 4
Mailing Address - City:LONDON
Mailing Address - State:KY
Mailing Address - Zip Code:40741-4021
Mailing Address - Country:US
Mailing Address - Phone:606-864-2541
Mailing Address - Fax:606-864-2570
Practice Address - Street 1:1114 REUBEN ST
Practice Address - Street 2:SUITE 4
Practice Address - City:LONDON
Practice Address - State:KY
Practice Address - Zip Code:40741-4021
Practice Address - Country:US
Practice Address - Phone:606-864-2541
Practice Address - Fax:606-864-2570
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-09
Last Update Date:2008-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY25120208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64251200Medicaid
KY64251200Medicaid