| 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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