Provider Demographics
NPI:1962419143
Name:HART, HAMILTON ROBERT (MD)
Entity type:Individual
Prefix:DR
First Name:HAMILTON
Middle Name:ROBERT
Last Name:HART
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:767 W NORTH ST
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72701-1865
Mailing Address - Country:US
Mailing Address - Phone:479-521-3600
Mailing Address - Fax:479-521-7422
Practice Address - Street 1:767 W NORTH ST
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:AR
Practice Address - Zip Code:72701-1865
Practice Address - Country:US
Practice Address - Phone:479-521-3600
Practice Address - Fax:479-521-7422
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARC4158207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR52214Medicare ID - Type Unspecified
ARC68454Medicare UPIN