Provider Demographics
NPI:1073162046
Name:MICHAEL A HART PLLC
Entity Type:Organization
Organization Name:MICHAEL A HART PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:ANDREW
Authorized Official - Last Name:HART
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:623-826-6000
Mailing Address - Street 1:5392 W TARO LN
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85308-4964
Mailing Address - Country:US
Mailing Address - Phone:623-826-6000
Mailing Address - Fax:623-572-7821
Practice Address - Street 1:5392 W TARO LN
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85308-4964
Practice Address - Country:US
Practice Address - Phone:623-826-6000
Practice Address - Fax:623-572-7821
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-11
Last Update Date:2019-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care