Hartsock, Terrance R
Hartsock, Terrance R is an individual health care provider with primary practice located at 650 Joel Dr , Fort Campbell KY 42223-5318. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Medical, which is considered as his primary health care specialty. Hartsock, Terrance R can be contacted via phone (270) 956-0650.Contact Information
Primary practice address
650 Joel Dr
Fort Campbell KY 42223-5318
Phone: (270) 956-0650
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Medical | 363AM0700X | 716 | Tennessee |
Profile Details
| NPI number | 1104956028 |
|---|---|
| LBN Legal business name | Hartsock, Terrance R |
| Credentials | Physician's Assistant Certified (PA-C) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 7th, 2007 |
| Last updated | Dec 14th, 2018 - about 6 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 | 1104956028 | NPPES |
| Tennessee | MEDICAID | 36669332 | |
| Tennessee | Other | PA716 | |
| Tennessee | Other | 4166977 | |
| Tennessee | Other | 1104956028 |
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