Provider Demographics
NPI:1083641112
Name:HARTSFIELD, MICHAEL T (MD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:T
Last Name:HARTSFIELD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5750 BERRYHILL RD
Mailing Address - Street 2:
Mailing Address - City:MILTON
Mailing Address - State:FL
Mailing Address - Zip Code:32570-8276
Mailing Address - Country:US
Mailing Address - Phone:850-623-0543
Mailing Address - Fax:850-623-5479
Practice Address - Street 1:5750 BERRYHILL RD
Practice Address - Street 2:
Practice Address - City:MILTON
Practice Address - State:FL
Practice Address - Zip Code:32570-8276
Practice Address - Country:US
Practice Address - Phone:850-623-0543
Practice Address - Fax:850-623-5479
Is Sole Proprietor?:No
Enumeration Date:2006-06-26
Last Update Date:2010-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME26694207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL59110225OtherBCBS
FL057479100Medicaid
FL0906906OtherUNITED HEALTHCARE
AL20402OtherALACAID
FL17350OtherBCBS
FL200043487OtherRAILROAD MEDICARE
FL4380102OtherAETNA
FLZ054OtherHEALTHFIRST NETWORK
FL0906906OtherUNITED HEALTHCARE
FL4380102OtherAETNA
FLZ054OtherHEALTHFIRST NETWORK