Individual
JAYSON C HARTMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PAS
Contact information
Practice address
1400 HIGHLAND RD STE 1, RICHMOND, IN 47374-8810
(765) 935-8905
(765) 939-4200
Mailing address
1100 REID PKWY, MEDICAL STAFF SERVICES, RICHMOND, IN 47374-1157
(765) 935-8905
(765) 939-4200
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10001104A
IN
363A00000X
Physician Assistant
50.003006
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000768377
ANTHEM - REID HOSPITAL
—
05
—
0111096
—
OH
Enumeration date
08/11/2009
Last updated
02/04/2022
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