MEDICARE: DR. SHAWN T MILBURN 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	207LP2900X	Pain Medicine (Anesthesiology) Physician	53919	KY
2	207L00000X	Anesthesiology Physician	53919	KY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	7617067	OTHER		UNITED HEALTHCARE
2	000001489941	OTHER	KY	ANTHEM KY & IN
3	00297988	OTHER		SIHO
4	68597919	OTHER	KY	AETNA
5	1327389-0001	OTHER		OHIO WORKERS COMP
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	12299111	OTHER		PRIME HEALTH SERVICES
8	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
9	3787095	OTHER		CIGNA

General Provider Information

NPI Number	:	1841652872
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SHAWN T MILBURN MD

Provider Business Mailing Address
First Line	:	PO BOX 936
Second Line	:
City	:	LONDON
State	:	KY
Zip	:	40743-0936
Country	:	US
Telephone Number	:	606-330-7835
Fax Number	:	859-543-0994

Provider Business Practice Location Address
First Line	:	160 N EAGLE CREEK DR STE 303
Second Line	:
City	:	LEXINGTON
State	:	KY
Zip	:	40509-2124
Country	:	US
Telephone Number	:	859-264-9820
Fax Number	:	859-543-0994

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

Provider Enumeration Date	:	03/29/2016
Last Update Date	:	05/28/2026

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Directions to “ DR. SHAWN T MILBURN MD” Practice Location

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