Provider Demographics
NPI:1598756280
Name:HARTMAN, JAMES M (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:M
Last Name:HARTMAN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 790379
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63179-0379
Mailing Address - Country:US
Mailing Address - Phone:314-251-6394
Mailing Address - Fax:314-251-4235
Practice Address - Street 1:607 S NEW BALLAS RD
Practice Address - Street 2:STE 2300
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63141-8219
Practice Address - Country:US
Practice Address - Phone:314-251-6394
Practice Address - Fax:314-251-4235
Is Sole Proprietor?:No
Enumeration Date:2005-11-02
Last Update Date:2011-06-03
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Provider Licenses
StateLicense IDTaxonomies
MO106906207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO013013883Medicare PIN
MOF57147Medicare UPIN