Hazlett, Gary Robert
Hazlett, Gary Robert is an individual health care provider with primary practice located at 2401 W University Ave , Muncie IN 47303-3428. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Hospitalist. Allopathic & Osteopathic Physicians / Hospitalist is his primary health care specialty. Hazlett, Gary Robert can be contacted via phone (765) 747-3111.Contact Information
Primary practice address
2401 W University Ave
Muncie IN 47303-3428
Phone: (765) 747-3111
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 01031249A | Indiana |
| Allopathic & Osteopathic Physicians / Hospitalist | 208M00000X | 01031249A | Indiana |
Profile Details
| NPI number | 1932292737 |
|---|---|
| LBN Legal business name | Hazlett, Gary Robert |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 2nd, 2006 |
| Last updated | Feb 1st, 2021 - about 5 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1932292737 | NPPES |
| Indiana | Other | P00980457 | RR MEDICARE |
| Indiana | MEDICAID | 100106260A | RR MEDICARE |
| Indiana | Other | 110085001 | RR MEDICARE |
| Indiana | MEDICAID | 200986050 | RR MEDICARE |
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