Hartzog, Charles Wayne

Hartzog, Charles Wayne is an individual health care provider with primary practice located at 4294 Lomac St , Montgomery AL 36106-3604. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Orthopaedic Surgery, Allopathic & Osteopathic Physicians / Sports Medicine. Allopathic & Osteopathic Physicians / Sports Medicine is his primary health care specialty. Hartzog, Charles Wayne can be contacted via phone (334) 274-9000.

Contact Information

Primary practice address
4294 Lomac St Montgomery AL 36106-3604
Phone: (334) 274-9000
Fax: (334) 274-0857
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Orthopaedic Surgery 207X00000X 20880 Alabama
Allopathic & Osteopathic Physicians / Sports Medicine 207XX0005X 20880 Alabama

Profile Details

NPI number 1952388050
LBN Legal business name Hartzog, Charles Wayne
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 29th, 2005
Last updated Apr 11th, 2023 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1952388050 NPPES
Alabama MEDICAID 000032697
Alabama MEDICAID 000032885
Alabama Other 200028175
Alabama Other 6455
Alabama Other 940627
Alabama Other 0910085
Alabama Other 551322
Alabama Other 5977258
Alabama Other 51032697
Alabama Other 51032885

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