Provider Demographics
NPI:1265852586
Name:BYBEE, CARY RANDALL (MD)
Entity Type:Individual
Prefix:
First Name:CARY
Middle Name:RANDALL
Last Name:BYBEE
Suffix:
Gender:M
Credentials:MD
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 670
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97709-0670
Mailing Address - Country:US
Mailing Address - Phone:541-746-1166
Mailing Address - Fax:541-393-1607
Practice Address - Street 1:147 S 52ND PL
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:OR
Practice Address - Zip Code:97478-6210
Practice Address - Country:US
Practice Address - Phone:541-746-1166
Practice Address - Fax:541-393-1607
Is Sole Proprietor?:No
Enumeration Date:2014-04-25
Last Update Date:2020-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD187008207Q00000X
LA306730207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine