Healthcare Provider Details

I. General information

NPI: 1356316384
Provider Name (Legal Business Name): RICHARD OXFORD HARDY CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/22/2006
Last Update Date: 12/06/2021
Certification Date: 12/06/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2201 LEXINGTON AVENUE
ASHLAND KY
41101
US

IV. Provider business mailing address

PO BOX 2379
ASHLAND KY
41105-2379
US

V. Phone/Fax

Practice location:
  • Phone: 606-408-4000
  • Fax:
Mailing address:
  • Phone: 606-408-6200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number976A
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number3000976
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: