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General NPI Number Information
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NPI Number | 1881031151
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Entity Type | Organization
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Legal Business Name | JEFFREY HARTZELL MD PC
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Dates
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Enumeration Date | 05/28/2013
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Last Update Date | 02/28/2014
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Provider Practice Location Address
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Address Line | 2936 FRONTAGE RD
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City | WARSAW
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State | IN
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Zip | 46580-3914
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Country | US
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Telephone | 260-205-5634
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Fax |
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Provider Business Mailing Address
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Address Line | 10214 CHESTNUT PLAZA DR #231
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City | FORT WAYNE
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State | IN
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Zip | 46814-8970
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Country | US
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Telephone | 260-205-5634
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. JEFFREY HARTZELL
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Credential | M.D.
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Telephone | 260-205-5634
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number |
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License Number State | IN
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