MEDICARE: DR. BENJAMIN RANDALL HART M.D.

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	207RG0100X	Gastroenterology Physician	4301118734	MI
2	207RG0100X	Gastroenterology Physician	35.138576	OH
3	207R00000X	Internal Medicine Physician	4301104782	MI
4	390200000X	Student in an Organized Health Care Education/Training Program

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1609294271
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BENJAMIN RANDALL HART M.D.

Provider Business Mailing Address
First Line	:	3000 ARLINGTON AVE STOP 1108
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43614-2595
Country	:	US
Telephone Number	:	419-383-5322
Fax Number	:

Provider Business Practice Location Address
First Line	:	1125 HOSPITAL DR STE 1620
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43614-8001
Country	:	US
Telephone Number	:	419-383-6105
Fax Number	:	419-383-2874

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

Provider Enumeration Date	:	04/01/2014
Last Update Date	:	02/09/2026

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Directions to “ DR. BENJAMIN RANDALL HART M.D.” Practice Location

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