Healthcare Provider Details

I. General information

NPI: 1144353111
Provider Name (Legal Business Name): SCOTT D HART MALPC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/13/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 HEALING FARM LANE
MILL SPRING NC
28756
US

IV. Provider business mailing address

101 HEALING FARM LANE
MILL SPRING NC
28756
US

V. Phone/Fax

Practice location:
  • Phone: 828-894-7122
  • Fax: 828-894-7111
Mailing address:
  • Phone: 828-894-7122
  • Fax: 828-894-7111

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number4508
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: