Provider Demographics
NPI:1467557785
Name:HARTMAN FAMILY PHYSICIAN INC
Entity Type:Organization
Organization Name:HARTMAN FAMILY PHYSICIAN INC
Other - Org Name:JOHN R HARTMAN MD & ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:R
Authorized Official - Last Name:HARTMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:321-442-1214
Mailing Address - Street 1:825 EAST OAK ST
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34744
Mailing Address - Country:US
Mailing Address - Phone:321-442-1214
Mailing Address - Fax:321-442-1215
Practice Address - Street 1:825 EAST OAK ST
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34744
Practice Address - Country:US
Practice Address - Phone:321-442-1214
Practice Address - Fax:321-442-1215
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
K8908Medicare ID - Type Unspecified