Bobo, Michael Lee

Bobo, Michael Lee is an sole proprietor health care provider with primary practice located at 1109 Poplar Street , Murray KY 42071. He recently has 2 registered licenses in different health care specialties including Dental Providers / Oral and Maxillofacial Surgery, Allopathic & Osteopathic Physicians / Oral & Maxillofacial Surgery. Dental Providers / Oral and Maxillofacial Surgery is his primary health care specialty. Bobo, Michael Lee can be contacted via phone (270) 759-4063.

Contact Information

Primary practice address
1109 Poplar Street Murray KY 42071
Fax: (270) 759-4920
Website:

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Oral and Maxillofacial Surgery 1223S0112X 7465 DENTAL Kentucky
Dental Providers / Oral and Maxillofacial Surgery 1223S0112X 34759 Kentucky
Allopathic & Osteopathic Physicians / Oral & Maxillofacial Surgery 204E00000X 34759 Kentucky

Profile Details

NPI number 1417031436
LBN Legal business name Bobo, Michael Lee
Credentials DDS MD
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 25th, 2006
Last updated Jul 12th, 2012 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1417031436 NPPES
Kentucky MEDICAID 60000163
Kentucky MEDICAID 64011711

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