Provider Demographics
NPI:1659357598
Name:HARVEY, ROBERT DOYLE (PA-C)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:DOYLE
Last Name:HARVEY
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3704 NORTH BLVD
Mailing Address - Street 2:SUITE C
Mailing Address - City:ALEXANDRIA
Mailing Address - State:LA
Mailing Address - Zip Code:71301-3606
Mailing Address - Country:US
Mailing Address - Phone:318-443-4576
Mailing Address - Fax:318-449-5579
Practice Address - Street 1:3704 NORTH BLVD
Practice Address - Street 2:SUITE C
Practice Address - City:ALEXANDRIA
Practice Address - State:LA
Practice Address - Zip Code:71301-3606
Practice Address - Country:US
Practice Address - Phone:318-443-4576
Practice Address - Fax:318-449-5579
Is Sole Proprietor?:No
Enumeration Date:2005-12-22
Last Update Date:2016-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAA10515363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1629090Medicaid
LA5B059P528Medicare ID - Type Unspecified
LA1629090Medicaid
LA0867910001Medicare NSC