Provider Demographics
NPI:1679754824
Name:HART, NOAL ISAAC (MD)
Entity Type:Individual
Prefix:DR
First Name:NOAL
Middle Name:ISAAC
Last Name:HART
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2200 BERGQUIST DR
Mailing Address - Street 2:
Mailing Address - City:LACKLAND AFB
Mailing Address - State:TX
Mailing Address - Zip Code:78236-9907
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:AVIANO AIR BASE, VIA PORDENONE
Practice Address - Street 2:
Practice Address - City:AVIANO
Practice Address - State:PORDENONE
Practice Address - Zip Code:33080
Practice Address - Country:IT
Practice Address - Phone:314-632-5019
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-15
Last Update Date:2017-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE242332085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology