Individual provider · Type 1 NPI

Jack Prothero, PA-C

Surgical Physician Assistant · Monroeville, PA

NPI number 1851279962 Active

Practice location

2566 Haymaker Rd Ste 304
Monroeville, PA 15146-3555

Specialties and licenses

TaxonomyCodeLicense
Surgical Physician Assistant Primary 363AS0400XMA067306 (PA)

Surgical Physician Assistant: Definition to come...

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About NPI 1851279962

Jack Prothero, PA-C's National Provider Identifier is 1851279962, issued on Aug 26, 2025. The primary taxonomy on file is Surgical Physician Assistant (363AS0400X), and the practice location is in Monroeville, PA. The record was last updated on Dec 16, 2025.