MEDICARE: MEDICINE SPECIALISTS, INC.

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	207R00000X	Internal Medicine Physician		MO

General Provider Information

NPI Number	:	1588668172
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MEDICINE SPECIALISTS, INC.

Provider Business Mailing Address
First Line	:	PO BOX 857
Second Line	:
City	:	FARMINGTON
State	:	MO
Zip	:	63640-0857
Country	:	US
Telephone Number	:	573-756-6438
Fax Number	:	573-756-6439

Provider Business Practice Location Address
First Line	:	1103 WEBER RD
Second Line	:	STE 101
City	:	FARMINGTON
State	:	MO
Zip	:	63640-3326
Country	:	US
Telephone Number	:	573-756-6438
Fax Number	:	573-756-6439

Authorized Official
Title or Position	:	CEO
Name	:	JOHN A. HARTMAN
Credential	:	D.O.
Telephone Number	:	573-756-6438

Provider Enumeration Date	:	06/10/2005
Last Update Date	:	07/21/2022

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Directions to “MEDICINE SPECIALISTS, INC. ” Practice Location

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