MEDICARE: DR. ROBERT M GEVEDON MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207P00000X	Emergency Medicine Physician	29767	KY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1275562746
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBERT M GEVEDON MD

Provider Business Mailing Address
First Line	:	3650 RABBITS FOOT TRL APT 9
Second Line	:
City	:	LEXINGTON
State	:	KY
Zip	:	40503-3753
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2327 BUTTERMILK XING
Second Line	:
City	:	CRESCENT SPRINGS
State	:	KY
Zip	:	41017-1622
Country	:	US
Telephone Number	:	859-344-7900
Fax Number	:	859-344-0099

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/30/2006
Last Update Date	:	12/03/2018

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