Robert Louis Boden – Surgical Physician Assistant

Key facts

NPI: 1255463196
Entity type: Individual (NPI type 1)
Primary specialty: Surgical Physician Assistant 363AS0400X
License: SA044 (KY)
Practice address: 320 Skyview Dr
Paris, KY 40361-1039
Phone: (859) 514-6675
Fax: (859) 514-5962
NPI assigned: Mar 9, 2007
Sex: Male
Sole proprietor: No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

R.B. Surgical Assistants Surgical Technologist · Paris, KY · NPI 1144433145

NPD (past)

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): No

State licenses

License	State	Type	Specialty
SA044	KY	MD	Surgical Physician Assistant

Practice roles

Organization	Specialty	Status	New patients
R.B. Surgical Assistants		Past	Accepting new patients

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Surgical Physician Assistant	363AS0400X	SA044	KY	Yes

Addresses

Primary practice location

320 Skyview Dr
Paris, KY 40361-1039

Mailing address

PO Box 5327
Paris, KY 40362-5327
Phone (859) 514-6675

Other identifiers

Identifier	Type	State	Issuer
755	Other	KY	NSAA
SA044	Other	KY	KY BOARD OF MEDICAL LISCE

Other providers in Paris, KY

All providers in Paris, KY · Surgical Physician Assistant in Kentucky

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.