Provider Demographics
NPI:1841206745
Name:HART, DEBORAH J (MD)
Entity Type:Individual
Prefix:DR
First Name:DEBORAH
Middle Name:J
Last Name:HART
Suffix:
Gender:F
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:PO BOX 851598
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36685-1598
Mailing Address - Country:US
Mailing Address - Phone:251-639-0050
Mailing Address - Fax:888-463-8150
Practice Address - Street 1:7420 HITT RD
Practice Address - Street 2:SUITE B
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36695-4497
Practice Address - Country:US
Practice Address - Phone:251-639-0050
Practice Address - Fax:888-463-8150
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-31
Last Update Date:2017-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL000138472084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL000088728Medicaid
AL000088728Medicaid
000088728Medicare ID - Type Unspecified