Provider Demographics
NPI:1417996695
Name:YAPUNDICH, ROBERT ANTHONY (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:ANTHONY
Last Name:YAPUNDICH
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 27128
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84127-0128
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:652 S MEDICAL CENTER DR STE 320
Practice Address - Street 2:
Practice Address - City:ST GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84790-7266
Practice Address - Country:US
Practice Address - Phone:435-251-3950
Practice Address - Fax:435-251-3951
Is Sole Proprietor?:No
Enumeration Date:2006-06-05
Last Update Date:2023-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME1296482084N0400X
TN520382084N0400X
WAMD607840302084N0400X
UT9626704-1205208M00000X
NC96 001462084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNP01546082OtherRAILROAD MEDICARE
VA1417996695Medicaid
TNQ015366Medicaid
NC8988268Medicaid
VA1417996695Medicaid
TN103I135314Medicare PIN
TNQ015366Medicaid