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Individual

MR. JAMES KEVIN HART

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
76 COUNTY ROAD, SUITE 3, WOODLAND, AL 36280
(256) 449-2001
Mailing address
119 AMBULANCE DRIVE, SUITE 202, CARROLLTON, GA 30117-3857
(770) 838-8710
(770) 838-8563

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
003428
GA
363A00000X
Physician Assistant
Primary
PA.858
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100001778A
GA
01
970028537
RAIL ROAD MEDICARE
FL
Enumeration date
12/11/2006
Last updated
05/16/2014
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