Provider Demographics
NPI:1114243672
Name:CRAIG HARTMAN, D.O., LTD.
Entity Type:Organization
Organization Name:CRAIG HARTMAN, D.O., LTD.
Other - Org Name:SPRING VALLEY WOMEN'S HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:A
Authorized Official - Last Name:HARTMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:702-220-3223
Mailing Address - Street 1:5380 S RAINBOW BLVD
Mailing Address - Street 2:SUITE 108
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89118-1877
Mailing Address - Country:US
Mailing Address - Phone:702-220-3223
Mailing Address - Fax:702-368-0710
Practice Address - Street 1:5380 S RAINBOW BLVD
Practice Address - Street 2:SUITE 108
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89118-1877
Practice Address - Country:US
Practice Address - Phone:702-220-3223
Practice Address - Fax:702-368-0710
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-08
Last Update Date:2010-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV1136207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1366449100OtherINDIVIDUAL NPI
NV100507153Medicaid
I50770Medicare UPIN
NV100507153Medicaid