Bynum, Gus A
Bynum, Gus A is an individual health care provider with primary practice located at 1154A Lexington Rd , Georgetown KY 40324-9330. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Bynum, Gus A can be contacted via phone (502) 868-0008.Contact Information
Primary practice address
1154A Lexington Rd
Georgetown KY 40324-9330
Phone: (502) 868-0008
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 16936 | Kentucky |
Profile Details
| NPI number | 1023016391 |
|---|---|
| LBN Legal business name | Bynum, Gus A |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 12th, 2005 |
| Last updated | Dec 3rd, 2007 - about 18 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1023016391 | NPPES |
| Other | 000000049706 | ANTHEM | |
| MEDICAID | 64169360 | ANTHEM |
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