Irvin, Ethan

Irvin, Ethan is an sole proprietor health care provider with primary practice located at 655 7Th St Bldg 700 , Robins Afb GA 31098-2227. He recently has 2 registered licenses in different health care specialties including Other Service Providers / Military Health Care Provider, Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant. Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant is his primary health care specialty. Irvin, Ethan can be contacted via phone (478) 497-7569.

Contact Information

Primary practice address
655 7Th St Bldg 700 Robins Afb GA 31098-2227
Phone: (478) 497-7569
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Military Health Care Provider 171000000X
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X

Profile Details

NPI number 1538834619
LBN Legal business name Irvin, Ethan
Credentials PHYSICIAN ASSISTANT
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 11th, 2021
Last updated Jul 28th, 2023 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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