Organization
LARRY R. HART, M.D., L.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LARRY R. HART M.D. (OWNER)
(706) 283-1914
Entity
Organization
Contact information
Practice address
41 CHESTNUT ST, ELBERTON, GA 30635-1805
(706) 283-1914
(706) 283-1569
Mailing address
41 CHESTNUT ST, ELBERTON, GA 30635-1805
(706) 283-1914
(706) 283-1569
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
023060
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
197506
BCBS PROVIDER NUMBER
GA
01
—
GRP6319
MEDICARE GROUP NUMBER
GA
Enumeration date
01/24/2007
Last updated
08/22/2020
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