Hartsock, Stephen J
Hartsock, Stephen J is an individual health care provider with primary practice located at 1115 Ronald Reagan Pkwy Ste 148, Avon IN 46123-6910. He recently has 3 registered licenses in different health care specialties including Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Sports Medicine. Allopathic & Osteopathic Physicians / Sports Medicine is his primary health care specialty. Hartsock, Stephen J can be contacted via phone (317) 962-8893.Contact Information
Primary practice address
1115 Ronald Reagan Pkwy Ste 148
Avon IN 46123-6910
Phone: (317) 962-8893
Fax: (317) 962-6722
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Other Service Providers / Specialist | 174400000X | 036110046 | Illinois |
Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 01072804A | Indiana |
Allopathic & Osteopathic Physicians / Sports Medicine | 207QS0010X | 01072804A | Indiana |
Profile Details
NPI number | 1114938453 |
---|---|
LBN Legal business name | Hartsock, Stephen J |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Aug 11th, 2006 |
Last updated | Mar 7th, 2023 - about 2 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 | 1114938453 | NPPES |
Illinois | Other | 336070768 | CONTROLLED SUBSTANCE # |
Illinois | MEDICAID | 201166240 | CONTROLLED SUBSTANCE # |
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