Robert W Harrison, PA-C
Individual provider Active NPI Physician Assistant · Dayton, TN
NPI 1699705012 · NPPES record last updated Nov 16, 2007
Key facts
- NPI
- 1699705012
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- 000028 (TN)
- Practice address
- 9400 Rhea County Hwy
Dayton, TN 37321-7922 - Phone
- (423) 775-1121
- Fax
- (865) 291-3228
- NPI assigned
- Jul 3, 2006
- 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)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 000028 | TN | MD | Physician Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 000028 | TN | Yes |
Addresses
Primary practice location
9400 Rhea County Hwy
Dayton, TN 37321-7922
Mailing address
PO Box 634909
Cincinnati, OH 45263-4909
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4068966 | Other | TN | BCBS OF TENNESSEE |
| 3669426 | Medicaid | TN |
Other providers in Dayton, TN
- Eva Hampton
- Sabrina Hanley
- Sarah Harrell
- Harris Hometown Dentistry PLLC
- Lauren Elaine Harris
- Healthforce of Dayton, Inc
- Zoa Henderson
- Mary Catherine Hendren
- Paul Meredith Hendricks
- Timothy J Henry
All providers in Dayton, TN · Physician Assistant in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 16, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.