MEDICARE: DR. CRAIG ANTHONY HARTMAN D.O.

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	207V00000X	Obstetrics & Gynecology Physician	1136	NV

General Provider Information

NPI Number	:	1366449100
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CRAIG ANTHONY HARTMAN D.O.

Provider Business Mailing Address
First Line	:	5380 S RAINBOW BLVD
Second Line	:	SUITE 108
City	:	LAS VEGAS
State	:	NV
Zip	:	89118-1877
Country	:	US
Telephone Number	:	702-220-3223
Fax Number	:	702-368-0710

Provider Business Practice Location Address
First Line	:	5380 S RAINBOW BLVD
Second Line	:	SUITE 108
City	:	LAS VEGAS
State	:	NV
Zip	:	89118-1877
Country	:	US
Telephone Number	:	702-220-3223
Fax Number	:	702-368-0710

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

Provider Enumeration Date	:	07/07/2005
Last Update Date	:	07/08/2007

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