Individual
RICHARD J HARTLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5424 DISCOVERY PARK BLVD, SUITE 104, WILLIAMSBURG, VA 23188-2862
(757) 206-1190
(757) 208-0601
Mailing address
860 OMNI BLVD, SUITE 303, NEWPORT NEWS, VA 23606-4430
(757) 232-8769
(757) 232-8875
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
0101049148
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
097290
ANTHEM
—
01
—
110075685
MC RAILROAD
—
01
—
4299917
AETNA
—
01
—
541659020
PHCS
—
01
—
55883
OPTIMA
—
01
—
859001
MAILHANDLERS
—
Enumeration date
08/14/2006
Last updated
12/06/2019
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