Provider Demographics
NPI:1629031786
Name:PYATT, ROBERT S JR (MD)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:S
Last Name:PYATT
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:25 PENNCRAFT AVE
Mailing Address - Street 2:SUITE E
Mailing Address - City:CHAMBERSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17201-5600
Mailing Address - Country:US
Mailing Address - Phone:717-263-1383
Mailing Address - Fax:717-263-7434
Practice Address - Street 1:144 S 8TH ST STE 108
Practice Address - Street 2:
Practice Address - City:CHAMBERSBURG
Practice Address - State:PA
Practice Address - Zip Code:17201-2752
Practice Address - Country:US
Practice Address - Phone:717-263-1383
Practice Address - Fax:717-263-7434
Is Sole Proprietor?:No
Enumeration Date:2006-04-10
Last Update Date:2024-02-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD021565E2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0008984850003Medicaid
MD326081000Medicaid
NY02668211Medicaid
MD326081000Medicaid
PA0008984850003Medicaid