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General NPI Number Information
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NPI Number | 1720012271
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Entity Type | Individual
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Provider Name | BOYD KENT HARTMAN M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/10/2006
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | 2312 SOUTH 6TH STREET, SUITE F256 / 2B WEST UNIVERSITY OF MINNESOTA PHYSICIANS
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City | MINNEAPOLIS
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State | MN
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Zip | 55454
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Country | US
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Telephone | 612-273-8700
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Fax |
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Provider Business Mailing Address
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Address Line | 420 DELAWARE STREET SE UNIVERSITY OF MINNESOTA PHYSICIANS, MMC 392
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City | MINNEAPOLIS
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State | MN
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Zip | 55455
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Country | US
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Telephone | 612-273-9800
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 31425
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License Number State | MN
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