Basic Information
Provider Information
NPI: 1134207061
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ZIRKLE
FirstName: ROBERT
MiddleName: S
NamePrefix: MR.
NameSuffix:  
Credential: PA-C
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 565 COAL VALLEY RD
Address2:  
City: JEFFERSON HILLS
State: PA
PostalCode: 150253703
CountryCode: US
TelephoneNumber: 4122676810
FaxNumber: 4122676817
Practice Location
Address1: 565 COAL VALLEY RD
Address2:  
City: JEFFERSON HILLS
State: PA
PostalCode: 150253703
CountryCode: US
TelephoneNumber: 4122676810
FaxNumber: 4122676817
Other Information
ProviderEnumerationDate: 11/01/2006
LastUpdateDate: 10/08/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 10/08/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363AM0700XMA051969PAY Physician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical

No ID Information.


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