Healthcare Provider Details

I. General information

NPI: 1942203286
Provider Name (Legal Business Name): ERIC DAVID HARDING MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/31/2005
Last Update Date: 04/05/2024
Certification Date: 04/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

118 FAIRFIELD DR INTERNAL MEDICINE AND PEDIATRIC CLINIC OF NEW ALBANY
NEW ALBANY MS
38652
US

IV. Provider business mailing address

118 FAIRFIELD DR
NEW ALBANY MS
38652
US

V. Phone/Fax

Practice location:
  • Phone: 662-534-0898
  • Fax: 662-534-8905
Mailing address:
  • Phone: 662-534-0898
  • Fax: 662-534-8905

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number14461
License Number StateMS
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number14461
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: