Provider Demographics
NPI:1316177306
Name:HART, PHILIP LAWRENCE (MD)
Entity type:Individual
Prefix:DR
First Name:PHILIP
Middle Name:LAWRENCE
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 1:17B UNION ST
Mailing Address - Street 2:
Mailing Address - City:UNIONTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15401-4217
Mailing Address - Country:US
Mailing Address - Phone:724-437-9581
Mailing Address - Fax:
Practice Address - Street 1:2 W MAIN ST
Practice Address - Street 2:
Practice Address - City:UNIONTOWN
Practice Address - State:PA
Practice Address - Zip Code:15401-3408
Practice Address - Country:US
Practice Address - Phone:772-283-1165
Practice Address - Fax:772-463-2301
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-23
Last Update Date:2016-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD011187E2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology