Individual
DR. MARCY A. HARTLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
865 BEAVER DR, DU BOIS, PA 15801
(814) 371-1510
(814) 371-2922
Mailing address
100 HOSPITAL AVE, DU BOIS, PA 15801-1440
(814) 371-1510
(814) 371-2922
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
MD453017
PA
208000000X
Pediatrics Physician
Primary
ME161877
FL
2080A0000X
Pediatric Adolescent Medicine Physician
161877
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
016848817
—
NY
05
—
101066300
—
FL
Enumeration date
03/09/2006
Last updated
10/29/2019
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