Healthcare Provider Details

I. General information

NPI: 1215937537
Provider Name (Legal Business Name): TIMOTHY SCOTT HARTON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/28/2005
Last Update Date: 10/15/2021
Certification Date: 10/15/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

94 MAIN ST.
CASSVILLE MO
65625
US

IV. Provider business mailing address

PO BOX 10
CAVE SPRINGS AR
72718
US

V. Phone/Fax

Practice location:
  • Phone: 417-847-6000
  • Fax: 870-226-6554
Mailing address:
  • Phone: 479-360-9993
  • Fax: 952-442-3620

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberE3166
License Number StateAR
# 2
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberE-3166
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: