| Gus A. Bynum, M.D., P.S.C. | |
|
1154 Lexington Rd # A Georgetown KY 40324-9330 | |
| (502) 868-0008 | |
| Not Available |
| Full Name | Gus A. Bynum, M.D., P.S.C. |
|---|---|
| Speciality | Family Medicine |
| Location | 1154 Lexington Rd # A, Georgetown, Kentucky |
| Authorized Official Name and Position | Gus a Bynum (PRESIDENT) |
| Authorized Official Contact | 5028680008 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Gus A. Bynum, M.D., P.S.C. 1154 Lexington Rd # A Georgetown KY 40324-9330 Ph: (502) 868-0008 | Gus A. Bynum, M.D., P.S.C. 1154 Lexington Rd # A Georgetown KY 40324-9330 Ph: (502) 868-0008 |
| NPI Number | 1538250832 |
|---|---|
| Provider Enumeration Date | 09/28/2006 |
| Last Update Date | 05/14/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538250832 | NPI | - | NPPES |
| 78901105 | Medicaid | KY | |
| 65904534 | Medicaid | KY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | () | Primary |
| 363L00000X | Nurse Practitioner | () | Secondary |
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