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Individual

DR. RONALD L HART

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
3685 BRASELTON HWY, SUITE 100, DACULA, GA 30019-5920
(678) 546-9800
(678) 344-8600
Mailing address
2878 FIVE FORKS TRICKUM RD, 2A, LAWRENCEVILLE, GA 30044-5896
(678) 344-8700
(678) 377-8600

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
046115
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000841882AF
GA
05
000841882AI
GA
Enumeration date
06/24/2005
Last updated
04/09/2012
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