Healthcare Provider Details
I. General information
NPI: 1225190226
Provider Name (Legal Business Name): ROBERT THOMAS BYINGTON MD OBGYN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 12/15/2006
Last Update Date: 07/22/2015
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1530S 70TH ST 100
LINCOLN NE
68506-1567
US
IV. Provider business mailing address
1530 S 70TH STREET STE 100
LINCOLN NE
68506
US
V. Phone/Fax
- Phone: 402-488-2348
- Fax: 402-488-2463
- Phone: 402-488-2359
- Fax: 402-488-2463
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207V00000X |
| Taxonomy | Obstetrics & Gynecology Physician |
| License Number | 12372 |
| License Number State | NE |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: