Individual
DR. RUSSELL W HART
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
8072 NORMANDY DR, FORT RILEY, KS 66442-7069
(785) 240-5516
(785) 239-4065
Mailing address
650 HUEBNER RD, FORT RILEY, KS 66442-4030
(785) 240-5517
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1396-3
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100219860E
—
KS
01
—
651142
BCBS
KS
Enumeration date
09/12/2005
Last updated
08/16/2022
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