Individual
DR. GUS A BYNUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1154A LEXINGTON RD, GEORGETOWN, KY 40324-9330
(502) 868-0008
Mailing address
1154A LEXINGTON RD, GEORGETOWN, KY 40324-9330
(502) 868-0008
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
16936
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000049706
ANTHEM
—
05
—
64169360
—
KY
Enumeration date
07/12/2005
Last updated
12/03/2007
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