Healthcare Provider Details

I. General information

NPI: 1629021415
Provider Name (Legal Business Name): PAUL D HART MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/19/2006
Last Update Date: 07/10/2026
Certification Date: 07/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2190 HIGHWAY 85 N
NICEVILLE FL
32578-1045
US

IV. Provider business mailing address

2190 HIGHWAY 85 N
NICEVILLE FL
32578-1045
US

V. Phone/Fax

Practice location:
  • Phone: 850-729-9407
  • Fax: 850-729-9418
Mailing address:
  • Phone: 850-729-9407
  • Fax: 850-729-9418

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberMD.28985
License Number StateAL
# 2
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberME80968
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: