MEDICARE: DR. JOHN NAMON HARTSON PH.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	103T00000X	Psychologist	496	IA

General Provider Information

NPI Number	:	1780613356
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHN NAMON HARTSON PH.D.

Provider Business Mailing Address
First Line	:	1027 ROCHESTER AVE
Second Line	:
City	:	IOWA CITY
State	:	IA
Zip	:	52245-3125
Country	:	US
Telephone Number	:	319-338-9960
Fax Number	:	319-338-9492

Provider Business Practice Location Address
First Line	:	1027 ROCHESTER AVE
Second Line	:
City	:	IOWA CITY
State	:	IA
Zip	:	52245-3125
Country	:	US
Telephone Number	:	319-338-9960
Fax Number	:	319-338-9492

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

Provider Enumeration Date	:	07/03/2006
Last Update Date	:	07/08/2007

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