Provider Demographics
NPI:1073571097
Name:HARTMAN, COBY L (DO)
Entity Type:Individual
Prefix:DR
First Name:COBY
Middle Name:L
Last Name:HARTMAN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1040 TOWNE SQUARE DR
Mailing Address - Street 2:
Mailing Address - City:GREENSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15601-5787
Mailing Address - Country:US
Mailing Address - Phone:724-836-0190
Mailing Address - Fax:724-837-4350
Practice Address - Street 1:1040 TOWNE SQUARE DR
Practice Address - Street 2:
Practice Address - City:GREENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15601-5787
Practice Address - Country:US
Practice Address - Phone:724-836-0190
Practice Address - Fax:724-837-4350
Is Sole Proprietor?:No
Enumeration Date:2006-05-01
Last Update Date:2023-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS013662207W00000X, 207WX0107X, 207W00000X
NY239792207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Yes207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1021988270001Medicaid