Provider Demographics
NPI:1538136304
Name:BAYUK, ROBERT J (EDD PSYCHOLOGIST)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:J
Last Name:BAYUK
Suffix:
Gender:M
Credentials:EDD PSYCHOLOGIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 251
Mailing Address - Street 2:
Mailing Address - City:WORLAND
Mailing Address - State:WY
Mailing Address - Zip Code:82401-3514
Mailing Address - Country:US
Mailing Address - Phone:307-347-8411
Mailing Address - Fax:307-347-8411
Practice Address - Street 1:1300 COBURN AV
Practice Address - Street 2:
Practice Address - City:WORLAND
Practice Address - State:WY
Practice Address - Zip Code:82401-3514
Practice Address - Country:US
Practice Address - Phone:307-347-8411
Practice Address - Fax:307-347-8411
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-01
Last Update Date:2010-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY139103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WYW23540Medicare PIN
WYW23541Medicare PIN