Provider Demographics
NPI:1093042772
Name:HARSH, ROBERT LYNN (PA-C)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:LYNN
Last Name:HARSH
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 1:1 AMALIA DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:BUCKHANNON
Mailing Address - State:WV
Mailing Address - Zip Code:26201-2239
Mailing Address - Country:US
Mailing Address - Phone:304-473-2303
Mailing Address - Fax:304-473-2313
Practice Address - Street 1:402 MEDICAL PARK DR
Practice Address - Street 2:SUITE 100
Practice Address - City:WESTON
Practice Address - State:WV
Practice Address - Zip Code:26452-1678
Practice Address - Country:US
Practice Address - Phone:304-269-3929
Practice Address - Fax:304-269-3911
Is Sole Proprietor?:No
Enumeration Date:2009-11-17
Last Update Date:2024-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV470363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical