MEDICARE: DR. JOHN PAUL HARTMAN NMD

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	175F00000X	Naturopath	94-457	AZ

General Provider Information

NPI Number	:	1912234576
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHN PAUL HARTMAN NMD

Provider Business Mailing Address
First Line	:	14281 E PLACITA LAGO VERDE
Second Line	:
City	:	VAIL
State	:	AZ
Zip	:	85641-0180
Country	:	US
Telephone Number	:	928-812-2152
Fax Number	:

Provider Business Practice Location Address
First Line	:	13180 E COLOSSAL CAVE RD STE 140
Second Line	:
City	:	VAIL
State	:	AZ
Zip	:	85641-9794
Country	:	US
Telephone Number	:	928-812-2152
Fax Number	:

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

Provider Enumeration Date	:	11/03/2009
Last Update Date	:	12/11/2020

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