# MR. THOMAS MARK HARTLEY

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1164407391
- **Gender:** Man
- **Credential:** M.D.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207X00000X | Orthopaedic Surgery Physician | 100628 | MO | — |
| 207X00000X | Orthopaedic Surgery Physician | G89301 | CA | Yes |

## Other

- **Enumeration date:** 12/09/2005
- **Last updated:** 07/13/2018

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1093058 | UNITED HEALTH CARE | — |
| 01 | — | 1164407391 | COVENTRY | — |
| 01 | — | 18475026 | BCBS | — |
| 01 | — | 3076318 | CIGNA | — |
| 01 | — | 4364771 | AETNA | — |
| 01 | — | P00455132 | RAILROAD MEDICARE | — |