| Michael L Bobo Dds Md Psc | |
| 
					1109 Poplar St Murray KY 42071-2360  | |
| (270) 759-4063 | |
| (270) 759-4920 | 
| Full Name | Michael L Bobo Dds Md Psc | 
|---|---|
| Speciality | Oral & Maxillofacial Surgery | 
| Location | 1109 Poplar St, Murray, Kentucky | 
| Authorized Official Name and Position | Michael L Bobo (OWNER/PRESIDENT) | 
| Authorized Official Contact | 2707594063 | 
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. | 
| Mailing Address | Practice Location Address | 
|---|---|
| Michael L Bobo Dds Md Psc 1109 Poplar St Murray KY 42071-2360 Ph: (270) 759-4063  | Michael L Bobo Dds Md Psc 1109 Poplar St Murray KY 42071-2360 Ph: (270) 759-4063  | 
| NPI Number | 1518141100 | 
|---|---|
| Provider Enumeration Date | 12/19/2007 | 
| Last Update Date | 08/04/2016 | 
| Medicare PECOS PAC ID | 0547209272 | 
|---|---|
| Medicare Enrollment ID | O20170112002608 | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1518141100 | NPI | - | NPPES | 
| 1518748 | Medicaid | TN | |
| 65934655 | Medicaid | KY | 
| Provider Name | Michael L Bobo | 
|---|---|
| Provider Type | Practitioner - Oral Surgery | 
| Provider Identifiers | NPI Number: 1417031436 PECOS PAC ID: 2264471994 Enrollment ID: I20070919000790  | 
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