Healthcare Provider Details

I. General information

NPI: 1811976509
Provider Name (Legal Business Name): RAYMOND P. HARTMAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/11/2006
Last Update Date: 10/03/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4 HOSPITAL DR
MORRILTON AR
72110-4510
US

IV. Provider business mailing address

PO BOX 1690
DANVILLE AR
72833-1690
US

V. Phone/Fax

Practice location:
  • Phone: 501-977-2200
  • Fax: 501-977-2398
Mailing address:
  • Phone: 479-495-5550
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberE-0669
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: