Provider Demographics
NPI:1205037801
Name:HARTMAN-HEANEY, TIPTON (DO)
Entity Type:Individual
Prefix:DR
First Name:TIPTON
Middle Name:
Last Name:HARTMAN-HEANEY
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 ELLIOT WAY
Mailing Address - Street 2:ELLIOT INTENSIVISTS
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03103-3502
Mailing Address - Country:US
Mailing Address - Phone:603-663-2231
Mailing Address - Fax:603-663-2353
Practice Address - Street 1:1 ELLIOT WAY
Practice Address - Street 2:ELLIOT INTENSIVISTS
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03103-3502
Practice Address - Country:US
Practice Address - Phone:603-663-2231
Practice Address - Fax:603-663-2353
Is Sole Proprietor?:No
Enumeration Date:2007-05-30
Last Update Date:2017-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036144619207RC0200X
NHLT-3186207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine