Provider Demographics
NPI:1780648501
Name:HART, DAVID ARTHUR (MD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:ARTHUR
Last Name:HART
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 1:320 SW CENTURY DR STE 405-318
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97702-3037
Mailing Address - Country:US
Mailing Address - Phone:541-897-8311
Mailing Address - Fax:541-897-8301
Practice Address - Street 1:320 SW CENTURY DR STE 405-318
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97702-3037
Practice Address - Country:US
Practice Address - Phone:541-897-8311
Practice Address - Fax:541-897-8301
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-17
Last Update Date:2023-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR195402084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
F40475Medicare UPIN