Individual
DR. STEPHEN WALLACE HARTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1200 N BEAVER ST, FLAGSTAFF, AZ 86001-3118
(928) 779-3366
Mailing address
1601 N FOX HILL RD, FLAGSTAFF, AZ 86004-7252
(928) 779-3366
Taxonomy
Speciality
Code
Description
License number
State
146D00000X
Personal Emergency Response Attendant
12105
AZ
207P00000X
Emergency Medicine Physician
12105
AZ
208D00000X
General Practice Physician
Primary
12105
AZ
Other
Enumeration date
07/20/2006
Last updated
07/16/2024
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