Basic Information
| Provider Information | |||||||||
| NPI: | 1851540454 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HARTZELL | ||||||||
| FirstName: | GEORGE | ||||||||
| MiddleName: | W. | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | JR. | ||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1605 N CEDAR CREST BLVD | ||||||||
| Address2: | STE 110B | ||||||||
| City: | ALLENTOWN | ||||||||
| State: | PA | ||||||||
| PostalCode: | 181042351 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6109731410 | ||||||||
| FaxNumber: | 6109731449 | ||||||||
| Practice Location | |||||||||
| Address1: | 798 HAUSMAN RD STE 250 | ||||||||
| Address2: | |||||||||
| City: | ALLENTOWN | ||||||||
| State: | PA | ||||||||
| PostalCode: | 181049116 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6109733868 | ||||||||
| FaxNumber: | 6109733867 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/18/2008 | ||||||||
| LastUpdateDate: | 01/17/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 01/17/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RG0300X | MD028050L | PA | N | Allopathic & Osteopathic Physicians | Internal Medicine | Geriatric Medicine | 208600000X | MD028050L | PA | N | Allopathic & Osteopathic Physicians | Surgery | 207R00000X | MD028050L | PA | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.