| Doctor Name: | MR. MARK ALAN HARTLEY |
| NPI Number: | 1124027685 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MPAS PA-C |
| License Number: | 1033608 |
| Business Practice Address: | 7950 Martin Loop Martin Army Community Hospital Fort Benning, GA - 319055647 |
| Business Phone Number: | 7065458543 |
| Business Fax Number: | |
| Mailing Address: | 1063 Lee Road 338, SALEM |
| State: | AL |
| Postal Code: | 368741219 |
| Phone Number: | 7067618293 |
| Fax Number: | |
| NPI Enumeration Date: | 07/18/2005 |
| NPI Last Update Date: | 10/26/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | 1033608 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | GA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |