Provider Demographics
NPI:1366464877
Name:AUSTIN, ANDREW ROBERT (PA-C)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:ROBERT
Last Name:AUSTIN
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1650 COCHRANE CIR, ATTN: CREDENTIALS OFFICE
Mailing Address - Street 2:EVANS ARMY COMMUNITY HOSPITAL (EACH) USA MEDDAC
Mailing Address - City:FT CARSON
Mailing Address - State:CO
Mailing Address - Zip Code:80913-4604
Mailing Address - Country:US
Mailing Address - Phone:719-526-7844
Mailing Address - Fax:719-526-7984
Practice Address - Street 1:1650 COCHRANE CIR, ATTN: CREDENTIALS OFFICE
Practice Address - Street 2:EVANS ARMY COMMUNITY HOSPITAL (EACH) USA MEDDAC
Practice Address - City:FT CARSON
Practice Address - State:CO
Practice Address - Zip Code:80913-4604
Practice Address - Country:US
Practice Address - Phone:719-524-4497
Practice Address - Fax:719-526-7404
Is Sole Proprietor?:No
Enumeration Date:2006-07-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1047002363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant