Robert Conrad Egbert Jr., PA

Individual provider Active NPI Medical Physician Assistant · Fort Knox, KY

NPI 1073596565 · NPPES record last updated Oct 24, 2014

Key facts

NPI
1073596565
Entity type
Individual (NPI type 1)
Primary specialty
Medical Physician Assistant 363AM0700X
Practice address
289 Ireland Ave
Irelandarmy Community Hospital
Fort Knox, KY 40121-5111
Phone
(502) 624-0406
Fax
(502) 624-0261
NPI assigned
Nov 29, 2005
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Physician Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X Yes

Addresses

Primary practice location

289 Ireland Ave
Irelandarmy Community Hospital
Fort Knox, KY 40121-5111

Mailing address

289 Ireland Ave
Irelandarmy Community Hospital
Fort Knox, KY 40121-5111

Other providers in Fort Knox, KY

All providers in Fort Knox, KY · Medical Physician Assistant in Kentucky

Sources for this page

Verify at the official NPI Registry.