Provider Demographics
NPI:1659377810
Name:HARTMAN, RONALD BLAIR (MD)
Entity Type:Individual
Prefix:DR
First Name:RONALD
Middle Name:BLAIR
Last Name:HARTMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5520 COLLEGE BLVD
Mailing Address - Street 2:STE 470
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66211-1694
Mailing Address - Country:US
Mailing Address - Phone:913-663-2345
Mailing Address - Fax:913-663-4325
Practice Address - Street 1:5520 COLLEGE BLVD
Practice Address - Street 2:STE 470
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66211-1694
Practice Address - Country:US
Practice Address - Phone:913-663-2345
Practice Address - Fax:913-662-4325
Is Sole Proprietor?:No
Enumeration Date:2005-06-22
Last Update Date:2007-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-18600207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
08558068OtherBCBS
MO5514497BMedicare PIN
5514497AMedicare ID - Type Unspecified
08558068OtherBCBS