Provider Demographics
NPI:1184655086
Name:HART, HARRY L (OD)
Entity Type:Individual
Prefix:DR
First Name:HARRY
Middle Name:L
Last Name:HART
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:855 HIGH ST
Mailing Address - Street 2:
Mailing Address - City:CHESTERTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21620
Mailing Address - Country:US
Mailing Address - Phone:410-778-3232
Mailing Address - Fax:410-778-1792
Practice Address - Street 1:855 HIGH ST
Practice Address - Street 2:
Practice Address - City:CHESTERTOWN
Practice Address - State:MD
Practice Address - Zip Code:21620
Practice Address - Country:US
Practice Address - Phone:410-778-3232
Practice Address - Fax:410-778-1792
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-06
Last Update Date:2008-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD626152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD802038800Medicaid
24998OtherJOHNS HOKINS
28900OtherCOVENTRY
MD110022664OtherMEDICARE RAILROAD
MD110022664OtherMEDICARE RAILROAD
28900OtherCOVENTRY
T59991Medicare UPIN