Provider Demographics
NPI:1861537326
Name:HARTONG, JOHN M (MD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:M
Last Name:HARTONG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1315 HOSPITAL DR
Mailing Address - Street 2:
Mailing Address - City:SAINT JOHNSBURY
Mailing Address - State:VT
Mailing Address - Zip Code:05819-9210
Mailing Address - Country:US
Mailing Address - Phone:802-748-7316
Mailing Address - Fax:802-748-7319
Practice Address - Street 1:1315 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:SAINT JOHNSBURY
Practice Address - State:VT
Practice Address - Zip Code:05819-9210
Practice Address - Country:US
Practice Address - Phone:802-748-7316
Practice Address - Fax:802-748-7319
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-21
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT04200009324208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
VTOVN1404Medicaid
HART 102-29069OtherVT BCBS
HART 102-29069OtherVT BCBS
VTOVN1404Medicaid
B97478Medicare UPIN