Healthcare Provider Details

I. General information

NPI: 1033148572
Provider Name (Legal Business Name): JOHN R HARDMAN MD, RP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/30/2006
Last Update Date: 03/16/2020
Certification Date: 03/16/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1693 QUENTIN ST
AURORA CO
80045-2518
US

IV. Provider business mailing address

12454 E ALASKA AVE
DENVER CO
80012-2354
US

V. Phone/Fax

Practice location:
  • Phone: 720-848-3000
  • Fax: 720-848-3015
Mailing address:
  • Phone: 623-225-1613
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberNLC0104740
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberNLC0104740
License Number StateCO
# 3
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberNLC0104740
License Number StateCO
# 4
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberACD.0000718
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: