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General NPI Number Information
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NPI Number | 1417215195
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Entity Type | Individual
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Provider Name | STEPHANIE ANNE HART M.D., MPH
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Gender | Female
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Dates
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Enumeration Date | 05/01/2012
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Last Update Date | 10/31/2017
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Provider Practice Location Address
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Address Line | 444 CLINCHFIELD ST STE 2900
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City | KINGSPORT
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State | TN
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Zip | 37660-3858
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Country | US
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Telephone | 423-245-6101
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Fax | 423-245-2396
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Provider Business Mailing Address
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Address Line | 105 W STONE DR STE 6A
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City | KINGSPORT
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State | TN
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Zip | 37660-3256
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Country | US
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Telephone | 423-408-7220
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Fax | 423-408-7405
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 56494
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License Number State | TN
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