Provider Demographics
NPI:1942426689
Name:HART, MARGARET JEAN (DO)
Entity Type:Individual
Prefix:DR
First Name:MARGARET
Middle Name:JEAN
Last Name:HART
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:SISTER EDITH
Other - Middle Name:MARY
Other - Last Name:HART
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DO
Mailing Address - Street 1:803 4TH ST
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MN
Mailing Address - Zip Code:56143-1056
Mailing Address - Country:US
Mailing Address - Phone:507-847-3571
Mailing Address - Fax:507-847-5664
Practice Address - Street 1:803 4TH ST
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MN
Practice Address - Zip Code:56143-1056
Practice Address - Country:US
Practice Address - Phone:507-847-3571
Practice Address - Fax:507-847-5664
Is Sole Proprietor?:No
Enumeration Date:2007-04-18
Last Update Date:2011-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN54437207Q00000X
MI5101016975207Q00000X
MI51O1016975207QG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN080021293OtherPTAN