Provider Demographics
NPI:1316229172
Name:HARTMAN, JOHN P (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:P
Last Name:HARTMAN
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2039 CHEYENNE TRL
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:IN
Mailing Address - Zip Code:47203-2088
Mailing Address - Country:US
Mailing Address - Phone:812-390-6150
Mailing Address - Fax:
Practice Address - Street 1:8945 MADISON AVE
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46227-6309
Practice Address - Country:US
Practice Address - Phone:317-859-0496
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-16
Last Update Date:2011-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26013786A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist