Basic Information
| Provider Information | |||||||||
| NPI: | 1518950302 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ROMINES | ||||||||
| FirstName: | ROBERT | ||||||||
| MiddleName: | BURNS | ||||||||
| NamePrefix: | MR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1698 OLD LEBANON RD | ||||||||
| Address2: | SUITE 2A | ||||||||
| City: | CAMPBELLSVILLE | ||||||||
| State: | KY | ||||||||
| PostalCode: | 427189662 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2707890587 | ||||||||
| FaxNumber: | 2707892025 | ||||||||
| Practice Location | |||||||||
| Address1: | 1698 OLD LEBANON RD | ||||||||
| Address2: | SUITE 2A | ||||||||
| City: | CAMPBELLSVILLE | ||||||||
| State: | KY | ||||||||
| PostalCode: | 427189662 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2707890587 | ||||||||
| FaxNumber: | 2707892025 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/26/2005 | ||||||||
| LastUpdateDate: | 09/27/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208600000X | 28637 | KY | Y | Allopathic & Osteopathic Physicians | Surgery | 208600000X | 00014180 | AL | N | Allopathic & Osteopathic Physicians | Surgery |
ID Information
| ID | Type | State | Issuer | Description | 64286370 | 05 | KY | MEDICAID | 000000051158 | 01 | KY | ANTHEM BC/BS | OTHER | 020026449 | 01 | KY | RR MEDICARE | OTHER | 1700387 | 01 | KY | UNITED HEALTH CARE | OTHER |