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General NPI Number Information
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NPI Number | 1558717595
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Entity Type | Organization
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Legal Business Name | SHIRLEY HARTMAN, MD, PA
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Dates
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Enumeration Date | 05/09/2016
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Last Update Date | 05/09/2016
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Provider Practice Location Address
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Address Line | 9283 SAN JOSE BLVD B-2 S1
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City | JACKSONVILLE
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State | FL
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Zip | 32257-5584
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Country | US
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Telephone | 904-268-5826
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Fax | 904-268-5873
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Provider Business Mailing Address
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Address Line | 9283 SAN JOSE BLVD B-2 S1
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City | JACKSONVILLE
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State | FL
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Zip | 32257-5584
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Country | US
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Telephone | 904-268-5826
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Fax | 904-268-5873
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SHIRLEY JOANNE HARTMAN
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Credential | M.D.
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Telephone | 904-268-5826
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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