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General NPI Number Information
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NPI Number | 1104246412
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Entity Type | Organization
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Legal Business Name | JAMES O. HARTSON, MD, LLC
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Dates
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Enumeration Date | 04/25/2014
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Last Update Date | 04/25/2014
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Provider Practice Location Address
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Address Line | 8865 W 400 N
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City | MICHIGAN CITY
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State | IN
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Zip | 46360-9222
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Country | US
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Telephone | 219-575-8516
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Fax |
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Provider Business Mailing Address
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Address Line | 8865 W 400 N
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City | MICHIGAN CITY
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State | IN
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Zip | 46360-9222
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Country | US
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Telephone | 219-575-8516
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN OWNER
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Name | DR. JAMES OLIVER HARTSON
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Credential | MD
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Telephone | 219-575-8516
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 01051992A
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License Number State | IN
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