Healthcare Provider Details

I. General information

NPI: 1598756280
Provider Name (Legal Business Name): JAMES M HARTMAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/02/2005
Last Update Date: 03/18/2025
Certification Date: 03/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1010 OLD DES PERES RD
SAINT LOUIS MO
63131-1865
US

IV. Provider business mailing address

PO BOX 14369
SAINT LOUIS MO
63178-4369
US

V. Phone/Fax

Practice location:
  • Phone: 314-822-5403
  • Fax: 314-822-5403
Mailing address:
  • Phone: 314-822-5403
  • Fax: 314-822-5403

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number106906
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: