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NPI Code Detail

MEDICARE: ROBERT C. L. HARTOG M.D.

MEDICARE: ROBERT C. L. HARTOG 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
1207Q00000XFamily Medicine PhysicianMD19203OR

Other Identifiers

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

General Provider Information

NPI Number : 1821063256
Entity Type Code : Individual
Provider Name (Legal Business Name) : ROBERT C. L. HARTOG M.D.
Provider Business Mailing Address
First Line : 2051 KAEN RD
Second Line : SUITE 367
City : OREGON CITY
State : OR
Zip : 97045-4035
Country : US
Telephone Number : 503-742-5300
Fax Number : 503-742-5304
Provider Business Practice Location Address
First Line : 1425 BEAVERCREEK RD
Second Line :
City : OREGON CITY
State : OR
Zip : 97045-4076
Country : US
Telephone Number : 503-655-8471
Fax Number : 503-655-8595
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/20/2006
Last Update Date : 04/30/2012

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