Provider Demographics
NPI:1982663308
Name:HARTY, JAMES RONALD (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:RONALD
Last Name:HARTY
Suffix:
Gender:M
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 168
Mailing Address - Street 2:
Mailing Address - City:HUMMELSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:17036-0168
Mailing Address - Country:US
Mailing Address - Phone:717-805-1046
Mailing Address - Fax:
Practice Address - Street 1:100 SOUTH FRONT STREET
Practice Address - Street 2:
Practice Address - City:LIVERPOOL
Practice Address - State:PA
Practice Address - Zip Code:17045
Practice Address - Country:US
Practice Address - Phone:717-805-1046
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-23
Last Update Date:2011-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD066304L207Q00000X, 207QG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
G56219Medicare UPIN
000088Medicare ID - Type Unspecified