Provider Demographics
NPI:1306047113
Name:HARTWELL FAMILY PRACTICE, P.C.
Entity type:Organization
Organization Name:HARTWELL FAMILY PRACTICE, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:EMORY
Authorized Official - Middle Name:W
Authorized Official - Last Name:WALKER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:706-376-3957
Mailing Address - Street 1:229 ATHENS ST
Mailing Address - Street 2:
Mailing Address - City:HARTWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30643-1854
Mailing Address - Country:US
Mailing Address - Phone:706-376-3957
Mailing Address - Fax:706-376-1356
Practice Address - Street 1:229 ATHENS ST
Practice Address - Street 2:
Practice Address - City:HARTWELL
Practice Address - State:GA
Practice Address - Zip Code:30643-1854
Practice Address - Country:US
Practice Address - Phone:706-376-3957
Practice Address - Fax:706-376-1356
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-30
Last Update Date:2023-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GACB5824OtherRAILROAD MEDICARE
GAGRP1617Medicare ID - Type Unspecified