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NPI Code Detail

MEDICARE: DR. TODD A HARTMAN O.D.

MEDICARE:  DR. TODD A HARTMAN  O.D.
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
1152W00000XOptometristNV 632NV

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1454366941OTHERNVOFFICE TAX ID
21992123244OTHERNVOFFICE NPI

General Provider Information

NPI Number : 1336226356
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. TODD A HARTMAN O.D.
Provider Business Mailing Address
First Line : 5705 CENTENNIAL CENTER BLVD
Second Line : SUITE 150
City : LAS VEGAS
State : NV
Zip : 89149-7128
Country : US
Telephone Number : 702-868-2020
Fax Number : 702-655-2050
Provider Business Practice Location Address
First Line : 5705 CENTENNIAL CENTER BLVD
Second Line : SUITE 150
City : LAS VEGAS
State : NV
Zip : 89149-7128
Country : US
Telephone Number : 702-868-2020
Fax Number : 702-655-2050
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/01/2006
Last Update Date : 04/04/2014

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Directions to “ DR. TODD A HARTMAN O.D.” Practice Location

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