Provider Demographics
NPI:1306815055
Name:HARTUNG, SCOTT J (DC)
Entity Type:Individual
Prefix:
First Name:SCOTT
Middle Name:J
Last Name:HARTUNG
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:615 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:REDFIELD
Mailing Address - State:SD
Mailing Address - Zip Code:57469-1209
Mailing Address - Country:US
Mailing Address - Phone:605-472-1405
Mailing Address - Fax:605-472-1408
Practice Address - Street 1:615 N MAIN ST
Practice Address - Street 2:
Practice Address - City:REDFIELD
Practice Address - State:SD
Practice Address - Zip Code:57469-1209
Practice Address - Country:US
Practice Address - Phone:605-472-1405
Practice Address - Fax:605-472-1408
Is Sole Proprietor?:No
Enumeration Date:2006-03-15
Last Update Date:2008-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD964111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD7601332Medicaid
SD0008336OtherBSSD
SD460408441OtherMEDICA
SD7601330Medicaid
SD7601333Medicaid
SD008448OtherBSSD
SD30426OtherSVHP
SD0008447OtherBSSD
SD0008447OtherBSSD
SD008448OtherBSSD
SD350052692Medicare PIN
SD0008336OtherBSSD
SDU86796Medicare UPIN