Provider Demographics
NPI:1457827065
Name:BUYS, ROBERT SCOTT (TRS/CTRS)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:SCOTT
Last Name:BUYS
Suffix:
Gender:M
Credentials:TRS/CTRS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:309 S 120 E
Mailing Address - Street 2:
Mailing Address - City:IVINS
Mailing Address - State:UT
Mailing Address - Zip Code:84738-6092
Mailing Address - Country:US
Mailing Address - Phone:801-376-1906
Mailing Address - Fax:
Practice Address - Street 1:1085 S BLUFF ST
Practice Address - Street 2:
Practice Address - City:ST GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84770-5245
Practice Address - Country:US
Practice Address - Phone:435-674-9999
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-22
Last Update Date:2018-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT6040522225800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRecreation Therapist