Provider Demographics
NPI:1376512285
Name:TRUSCOTT, BARBARA R (PA-C)
Entity Type:Individual
Prefix:MS
First Name:BARBARA
Middle Name:R
Last Name:TRUSCOTT
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:BARBARA
Other - Middle Name:R
Other - Last Name:HAUTZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:321 MAIN ST
Mailing Address - Street 2:SUITE 5H
Mailing Address - City:JOHNSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15901-1632
Mailing Address - Country:US
Mailing Address - Phone:814-535-3310
Mailing Address - Fax:814-532-6618
Practice Address - Street 1:100 HOSPITAL RD
Practice Address - Street 2:
Practice Address - City:PRINCE FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:20678-4017
Practice Address - Country:US
Practice Address - Phone:410-535-4000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-14
Last Update Date:2019-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA052236363AM0700X, 363AS0400X
MDC05674363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAP00759054OtherPALMETTO
PA001794440OtherGATEWAY MEDICARE ASSURED
PA161341L96OtherMEDICARE PTAN
PA001794440OtherSECURITY BLUE
PAQ58814Medicare UPIN