Provider Demographics
NPI:1255318408
Name:HARTMANN, WILLIAM PAUL III (MD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:PAUL
Last Name:HARTMANN
Suffix:III
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 1:4075 OLD WESTERN ROW RD
Mailing Address - Street 2:
Mailing Address - City:MASON
Mailing Address - State:OH
Mailing Address - Zip Code:45040-3104
Mailing Address - Country:US
Mailing Address - Phone:513-536-0232
Mailing Address - Fax:513-536-0609
Practice Address - Street 1:4075 OLD WESTERN ROW RD
Practice Address - Street 2:
Practice Address - City:MASON
Practice Address - State:OH
Practice Address - Zip Code:45040-3104
Practice Address - Country:US
Practice Address - Phone:513-536-0600
Practice Address - Fax:513-536-0609
Is Sole Proprietor?:No
Enumeration Date:2005-12-29
Last Update Date:2015-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-0790232084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH1841239274OtherMEDICARE NPI GROUP NUMBER
OH2404900Medicaid
OH9338635OtherMEDICARE GROUP NUMBER
OH1144401464OtherPRACTICE LOCATION NPI GROUP NUMBER
OH2774985OtherMEDICAID GROUP NUMBER
OH4066107Medicare PIN
OH1144401464OtherPRACTICE LOCATION NPI GROUP NUMBER