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General NPI Number Information
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NPI Number | 1457357642
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Entity Type | Individual
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Provider Name | ROY ALDEN HART DO
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Gender | Male
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Dates
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Enumeration Date | 06/22/2005
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Last Update Date | 05/20/2008
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Provider Practice Location Address
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Address Line | 1801 HICKMAN ROAD BROADLAWNS MEDICAL CENTER
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City | DES MOINES
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State | IA
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Zip | 50314
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Country | US
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Telephone | 515-282-2548
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Fax |
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Provider Business Mailing Address
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Address Line | 1801 HICKMAN ROAD BROADLAWNS MEDICAL CENTER
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City | DES MOINES
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State | IA
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Zip | 50314
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Country | US
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Telephone | 515-282-2548
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Fax |
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | 036081158
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 5315029112
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License Number State | MI
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