Individual
DR. KELLY ZACH HART
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
04-16575
KS
2085R0202X
Diagnostic Radiology Physician
2003007998
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100200880B
—
KS
05
—
203568712
—
MO
Enumeration date
06/15/2005
Last updated
08/01/2013
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