Provider Demographics
NPI:1891921631
Name:HARTMAN, LYNN ROBERT (DO)
Entity Type:Individual
Prefix:
First Name:LYNN
Middle Name:ROBERT
Last Name:HARTMAN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:710 S LINCOLN RD
Mailing Address - Street 2:
Mailing Address - City:ESCANABA
Mailing Address - State:MI
Mailing Address - Zip Code:49829-1292
Mailing Address - Country:US
Mailing Address - Phone:906-786-4628
Mailing Address - Fax:
Practice Address - Street 1:710 S LINCOLN RD
Practice Address - Street 2:
Practice Address - City:ESCANABA
Practice Address - State:MI
Practice Address - Zip Code:49829-1291
Practice Address - Country:US
Practice Address - Phone:906-786-4628
Practice Address - Fax:906-228-0167
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-08
Last Update Date:2015-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101018076207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine