Provider Demographics
NPI:1073596565
Name:EGBERT, ROBERT CONRAD JR (PA)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:CONRAD
Last Name:EGBERT
Suffix:JR
Gender:M
Credentials:PA
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Mailing Address - Street 1:289 IRELAND AVE
Mailing Address - Street 2:IRELANDARMY COMMUNITY HOSPITAL
Mailing Address - City:FORT KNOX
Mailing Address - State:KY
Mailing Address - Zip Code:40121-5111
Mailing Address - Country:US
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Practice Address - Street 1:289 IRELAND AVE
Practice Address - Street 2:IRELANDARMY COMMUNITY HOSPITAL
Practice Address - City:FORT KNOX
Practice Address - State:KY
Practice Address - Zip Code:40121-5111
Practice Address - Country:US
Practice Address - Phone:502-624-0406
Practice Address - Fax:502-624-0261
Is Sole Proprietor?:No
Enumeration Date:2005-11-29
Last Update Date:2014-10-24
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical