Hartman, Roderic Joel
Hartman, Roderic Joel is an individual health care provider with primary practice located at 1896 E Babbitt Lane , San Luis AZ 85349-1669. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Hartman, Roderic Joel can be contacted via phone (928) 722-6112.Contact Information
Primary practice address
1896 E Babbitt Lane
San Luis AZ 85349-1669
Phone: (928) 722-6112
Fax: (928) 722-6113
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | G87523 | California |
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 21315 | Arizona |
Profile Details
| NPI number | 1962607317 |
|---|---|
| LBN Legal business name | Hartman, Roderic Joel |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 17th, 2007 |
| Last updated | Oct 3rd, 2016 - about 8 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1962607317 | NPPES |
| Arizona | Other | 651170616 | TAX ID |
| Arizona | MEDICAID | 907349 | TAX ID |
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