Individual
JONATHAN D HART
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2605 E CREEKS EDGE DR, BLOOMINGTON, IN 47401-8368
(812) 355-2300
(812) 355-2316
Mailing address
2605 E CREEKS EDGE DR, BLOOMINGTON, IN 47401-8368
(812) 355-2300
(812) 355-2316
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
01039715
IN
207Q00000X
Family Medicine Physician
Primary
01039715A
IN
208M00000X
Hospitalist Physician
01039715A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200008900
—
IN
Enumeration date
01/12/2006
Last updated
09/09/2010
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