| Hart Family Medicine Pllc | |
|
107 E Holland Ave Spokane WA 99218-1209 | |
| (509) 466-3960 | |
| (509) 466-9566 |
| Full Name | Hart Family Medicine Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 107 E Holland Ave, Spokane, Washington |
| Authorized Official Name and Position | Brandi Wallen (BILLING/SUPPORT) |
| Authorized Official Contact | 5094663960 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Hart Family Medicine Pllc 107 E Holland Ave Spokane WA 99218-1209 Ph: (509) 466-3960 | Hart Family Medicine Pllc 107 E Holland Ave Spokane WA 99218-1209 Ph: (509) 466-3960 |
| NPI Number | 1508029844 |
|---|---|
| Provider Enumeration Date | 07/07/2008 |
| Last Update Date | 07/12/2010 |
| Medicare PECOS PAC ID | 2365517851 |
|---|---|
| Medicare Enrollment ID | O20080818000761 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508029844 | NPI | - | NPPES |
| 1124858 | Medicaid | WA | |
| 0229080 | Other | WA | WA DEPT OF LABOR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | OP00001655 (Washington) | Primary |
| Provider Name | Mark A Hart |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1013919927 PECOS PAC ID: 0042235004 Enrollment ID: I20051019000476 |
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