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Organization

ROBERT J. BUNGE, M.D., PSC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. ROBERT J. BUNGE M.D. (PRESIDENT)
(859) 223-6700
Entity
Organization

Contact information

Practice address
3121 WALL ST, LEXINGTON, KY 40513-1711
(859) 223-6700
(859) 223-5202
Mailing address
3121 WALL ST, LEXINGTON, KY 40513-1711
(859) 223-6700
(859) 223-5202

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
22523
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000048820
ANTHEM
KY
01
1396727079
INDIVIDUAL PROVIDER NPI
KY
05
64225238
KY
Enumeration date
04/18/2007
Last updated
07/25/2007
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