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General NPI Number Information
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NPI Number | 1427018019
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Entity Type | Individual
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Provider Name | RICHARD A. HARTERT JR. M.D.
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Gender | Male
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Dates
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Enumeration Date | 03/27/2006
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Last Update Date | 11/10/2015
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Provider Practice Location Address
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Address Line | 3599 UNIVERSITY BLVD S SUITE 1105
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City | JACKSONVILLE
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State | FL
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Zip | 32216-4285
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Country | US
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Telephone | 904-346-0703
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Fax | 904-346-3605
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Provider Business Mailing Address
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Address Line | PO BOX 16568
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City | JACKSONVILLE
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State | FL
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Zip | 32245-6568
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Country | US
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Telephone | 904-472-2300
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Fax | 904-472-2330
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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 | 207VG0400X
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Taxonomy Name | Gynecology Physician
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License Number | ME42728
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License Number State | FL
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