Provider Demographics
NPI:1699719658
Name:HARTLOVE, PETER TOWNSEND (DPM)
Entity type:Individual
Prefix:DR
First Name:PETER
Middle Name:TOWNSEND
Last Name:HARTLOVE
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1305 SUMNER ST
Mailing Address - Street 2:STE 200
Mailing Address - City:LONGMONT
Mailing Address - State:CO
Mailing Address - Zip Code:80501-3271
Mailing Address - Country:US
Mailing Address - Phone:303-772-3232
Mailing Address - Fax:303-772-2360
Practice Address - Street 1:1305 SUMNER ST
Practice Address - Street 2:STE 200
Practice Address - City:LONGMONT
Practice Address - State:CO
Practice Address - Zip Code:80501-3271
Practice Address - Country:US
Practice Address - Phone:303-772-3232
Practice Address - Fax:303-772-2360
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-16
Last Update Date:2008-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO326213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO0927888OtherAETNA
CO826480273OtherMEDICARE RAILROAD
CO84-1175163-01OtherPACIFICARE
CO01003268Medicaid
COC507708Medicare PIN
CO84-1175163-01OtherPACIFICARE