MEDICARE: MRS. DEBORAH HART PA-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	50.002065	OH
2	363A00000X	Physician Assistant	TC246	KY

General Provider Information

NPI Number	:	1134558927
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. DEBORAH HART PA-C

Provider Business Mailing Address
First Line	:	1169 EASTERN PKWY STE 400
Second Line	:
City	:	LOUISVILLE
State	:	KY
Zip	:	40217-1412
Country	:	US
Telephone Number	:	502-276-5554
Fax Number	:	502-403-2065

Provider Business Practice Location Address
First Line	:	6400 DUTCHMANS PKWY STE 60
Second Line	:
City	:	LOUISVILLE
State	:	KY
Zip	:	40205-3341
Country	:	US
Telephone Number	:	27-089-8805
Fax Number	:	502-708-6911

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/02/2013
Last Update Date	:	09/05/2025

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