Provider Demographics
NPI:1770657587
Name:HEARN, BRIAN BARTHOLOMEW (MD)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:BARTHOLOMEW
Last Name:HEARN
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 1:3805 HARDING RD
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:NY
Mailing Address - Zip Code:13323-4807
Mailing Address - Country:US
Mailing Address - Phone:315-853-5017
Mailing Address - Fax:315-853-5017
Practice Address - Street 1:1522 OLD BURRSTONE RD
Practice Address - Street 2:
Practice Address - City:UTICA
Practice Address - State:NY
Practice Address - Zip Code:13502-4804
Practice Address - Country:US
Practice Address - Phone:315-797-2450
Practice Address - Fax:315-792-4641
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-20
Last Update Date:2021-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD430316207V00000X
VA0101269563207V00000X
NY263045207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology