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Contact Information

MICHAEL L BOBO DDS MD PSC
1109 POPLAR ST
MURRAY, KY42071-2360
 Phone: 270-759-4063
 Fax: 270-759-4920
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Oral & Maxillofacial Surgery

204E00000X 02 Physician/General Surgery
 

Oral and Maxillofacial Surgery

1223S0112X 19 Oral Surgery (Dentist only)
Indicates primary specialty

NPI Profile & details for MICHAEL L BOBO DDS MD PSC

NPI Number 1518141100
LBN Legal business name MICHAEL L BOBO DDS MD PSC
Authorized official MICHAEL BOBO - (OWNER/PRESIDENT)
Entity Organization
Organization subpart 1 No
Enumeration date 12/19/2007
Last updated 08/04/2016 - About 10 years ago
Identifiers
KY License # 34759
KY License # 7465
TN License # 30866
TN License # 7404
KY Medicaid 65934655
TN Medicaid 1518748
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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