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General NPI Number Information
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NPI Number | 1184908246
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Entity Type | Organization
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Legal Business Name | WILLIAM G. HART, JR., INC.
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Dates
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Enumeration Date | 10/06/2011
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Last Update Date | 10/06/2011
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Provider Practice Location Address
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Address Line | 621 S NEW BALLAS RD STE. 676A
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City | SAINT LOUIS
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State | MO
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Zip | 63141-8232
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Country | US
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Telephone | 314-251-6250
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Fax |
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Provider Business Mailing Address
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Address Line | 621 S NEW BALLAS RD STE. 676A
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City | SAINT LOUIS
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State | MO
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Zip | 63141-8232
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Country | US
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Telephone | 314-251-6250
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. WILLIAM GARDNER HART JR.
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Credential | M.D.
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Telephone | 314-251-6250
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207ND0101X
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Taxonomy Name | MOHS-Micrographic Surgery Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207YS0123X
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Taxonomy Name | Facial Plastic Surgery Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207YX0007X
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Taxonomy Name | Plastic Surgery within the Head & Neck (Otolaryngology) Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 2082S0099X
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Taxonomy Name | Plastic Surgery Within the Head and Neck (Plastic Surgery) Physician
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 2082S0105X
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Taxonomy Name | Surgery of the Hand (Plastic Surgery) Physician
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 2086S0122X
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Taxonomy Name | Plastic and Reconstructive Surgery Physician
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number |
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License Number State |
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