Individual
DR. LAWRENCE P. HARTMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
135 W RAVINE RD, SUITE 4A, KINGSPORT, TN 37660-3847
(423) 392-9300
(423) 392-9365
Mailing address
135 W RAVINE RD, SUITE 4A, KINGSPORT, TN 37660-3847
(423) 392-9300
(423) 392-9365
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
36815
TN
332B00000X
Durable Medical Equipment & Medical Supplies
36815
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
177324
ANTHEM BCBS VA INDV
VA
05
—
3877574
—
TN
01
—
4103830
BCBS TN
TN
01
—
4205736
AETNA
TN
01
—
5803430001
DME NUMBER
TN
05
—
64059660
—
KY
01
—
9454636
CIGNA
TN
01
—
P00221383
RR MEDICARE
TN
Enumeration date
03/09/2006
Last updated
04/01/2008
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