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General NPI Number Information
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NPI Number | 1336680784
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Entity Type | Organization
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Legal Business Name | DAVID A HART MD PC
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Dates
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Enumeration Date | 03/18/2017
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Last Update Date | 03/18/2017
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Provider Practice Location Address
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Address Line | 1300 NW HARRISON BLVD SUITE B-10
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City | CORVALLIS
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State | OR
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Zip | 97330-6277
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Country | US
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Telephone | 541-738-2911
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Fax | 541-738-2738
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Provider Business Mailing Address
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Address Line | 1300 NW HARRISON BLVD SUITE B-10
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City | CORVALLIS
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State | OR
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Zip | 97330-6277
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Country | US
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Telephone | 541-738-2911
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Fax | 541-738-2738
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DAVID ARTHUR HART
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Credential | MD
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Telephone | 541-738-2911
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number | MD19540
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License Number State | OR
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