Provider Demographics
NPI:1679555296
Name:HYNICK, ROBERT (DO)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:
Last Name:HYNICK
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2796 LYCOMING MALL DR
Mailing Address - Street 2:
Mailing Address - City:MUNCY
Mailing Address - State:PA
Mailing Address - Zip Code:17756-6466
Mailing Address - Country:US
Mailing Address - Phone:570-546-5454
Mailing Address - Fax:570-546-5468
Practice Address - Street 1:2796 LYCOMING MALL DR
Practice Address - Street 2:
Practice Address - City:MUNCY
Practice Address - State:PA
Practice Address - Zip Code:17756-6466
Practice Address - Country:US
Practice Address - Phone:570-546-5454
Practice Address - Fax:570-546-5468
Is Sole Proprietor?:No
Enumeration Date:2005-11-18
Last Update Date:2012-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA05004400L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1684769OtherBLUE SHIELD
PAP00176021OtherRAILROAD MEDICARE
F06510Medicare UPIN
PA1684769OtherBLUE SHIELD