Healthcare Provider Details

I. General information

NPI: 1770191470
Provider Name (Legal Business Name): ROBERT ADAM HARDY DNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: ADAM HARDY DNP

II. Dates (important events)

Enumeration Date: 07/19/2020
Last Update Date: 09/08/2020
Certification Date: 09/08/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3651 WHEELER RD
AUGUSTA GA
30909-6426
US

IV. Provider business mailing address

2000 HEALTH PARK DR
BRENTWOOD TN
37027-4525
US

V. Phone/Fax

Practice location:
  • Phone: 706-651-2420
  • Fax:
Mailing address:
  • Phone: 615-372-5068
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN258309
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: