MEDICARE: RICHARD M DARTT PSC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner	3002678	KY
2	363A00000X	Physician Assistant	PA979	KY
3	207Q00000X	Family Medicine Physician	34877	KY

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	CJ7187	OTHER		RAILROAD MEDICARE PART B

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1063691590
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RICHARD M DARTT PSC

Provider Business Mailing Address
First Line	:	106 COMMERCIAL DR
Second Line	:
City	:	HARRODSBURG
State	:	KY
Zip	:	40330-1084
Country	:	US
Telephone Number	:	859-734-3482
Fax Number	:	859-734-3432

Provider Business Practice Location Address
First Line	:	106 COMMERCIAL DR
Second Line	:
City	:	HARRODSBURG
State	:	KY
Zip	:	40330-1084
Country	:	US
Telephone Number	:	859-734-3482
Fax Number	:	859-734-3432

Authorized Official
Title or Position	:	M.D
Name	:	DR. RICHARD M DARTT
Credential	:	M.D
Telephone Number	:	859-734-3482

Provider Enumeration Date	:	11/01/2007
Last Update Date	:	05/01/2012

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