MEDICARE: DR. PHILIP HARTWELL MD

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	207Q00000X	Family Medicine Physician	8286	NV

General Provider Information

NPI Number	:	1437171253
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PHILIP HARTWELL MD

Provider Business Mailing Address
First Line	:	296 W CAMELLIA CIR
Second Line	:
City	:	MESQUITE
State	:	NV
Zip	:	89027-5114
Country	:	US
Telephone Number	:	702-556-7316
Fax Number	:

Provider Business Practice Location Address
First Line	:	210 N SANDHILL BLVD
Second Line	:
City	:	MESQUITE
State	:	NV
Zip	:	89027-4789
Country	:	US
Telephone Number	:	702-849-0558
Fax Number	:	702-346-2147

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

Provider Enumeration Date	:	07/24/2006
Last Update Date	:	03/31/2023

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