Healthcare Provider Details

I. General information

NPI: 1194837336
Provider Name (Legal Business Name): THOMAS ROBERT HARDING MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 12/19/2025
Certification Date: 12/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4230 COPPER RIDGE DR
TRAVERSE CITY MI
49684-7256
US

IV. Provider business mailing address

7033 E TUDOR RD
ANCHORAGE AK
99507-1262
US

V. Phone/Fax

Practice location:
  • Phone: 231-935-6380
  • Fax:
Mailing address:
  • Phone: 907-729-8901
  • Fax: 907-729-6353

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number186554
License Number StateAK
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number9701761
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number26381020
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: