MEDICARE: PAUL R HARTMANN 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	24501	IA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	41550	OTHER	WELLMARK BC/BS
3	4796890008	OTHER	DMERC
4	19916	OTHER	IOWA HEALTH SOLUTIONS
5	IA0175	OTHER	JOHN DEERE HEALTH PLAN
6	077674	OTHER	HEALTH ALLIANCE

General Provider Information

NPI Number	:	1508861055
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PAUL R HARTMANN MD

Provider Business Mailing Address
First Line	:	865 LINCOLN RD
Second Line	:	STE L10
City	:	BETTENDORF
State	:	IA
Zip	:	52722-4159
Country	:	US
Telephone Number	:	563-355-9191
Fax Number	:	563-355-3419

Provider Business Practice Location Address
First Line	:	1520 W 53RD ST
Second Line	:	STE 1
City	:	DAVENPORT
State	:	IA
Zip	:	52806-2440
Country	:	US
Telephone Number	:	563-421-4900
Fax Number	:	563-421-4910

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

Provider Enumeration Date	:	06/20/2005
Last Update Date	:	07/09/2007

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Directions to “ PAUL R HARTMANN MD” Practice Location

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