Provider Demographics
NPI:1710181177
Name:HARTWELL, RICK LEE
Entity Type:Individual
Prefix:DR
First Name:RICK
Middle Name:LEE
Last Name:HARTWELL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1821 W HARBORLIGHT ST
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67204-2574
Mailing Address - Country:US
Mailing Address - Phone:316-832-1250
Mailing Address - Fax:316-832-1250
Practice Address - Street 1:1821 W HARBORLIGHT ST
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67204-2574
Practice Address - Country:US
Practice Address - Phone:316-832-1250
Practice Address - Fax:316-832-1250
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS0420015207QH0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QH0002XAllopathic & Osteopathic PhysiciansFamily MedicineHospice and Palliative Medicine