Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Ethan Irvin, PHYSICIANASSISTANT

Individual provider Military Health Care Provider · NPI 1538834619

Ethan Irvin, PHYSICIANASSISTANT is a Military Health Care Provider in Robins AFB, Georgia. Practices as a sole proprietor. Registered with an NPI since 2021.

In the registry since
2021
Specialties on file
2

Practice location Address checks out

655 7th St Bldg 700
Robins AFB, GA 31098-2227
Phone: (478) 497-7569
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X
Military Health Care Provider Taxonomy 171000000X

Record details

NPI number1538834619
Entity typeIndividual (Type 1)
GenderMale
Credentials PHYSICIANASSISTANT
Sole proprietorYes
NPI enumeratedAugust 11, 2021
Last updated in NPPESJuly 28, 2023
Certification dateJuly 28, 2023
Mailing address2803 Medical Campus Dr, Goldsboro, NC 27531

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