Healthcare Provider Details

I. General information

NPI: 1316901788
Provider Name (Legal Business Name): JEFFREY M HARDIN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/13/2006
Last Update Date: 08/22/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 HOSPITAL DR STE 3B
HENDERSONVILLE NC
28792-5245
US

IV. Provider business mailing address

PO BOX 1869
FLETCHER NC
28732-1869
US

V. Phone/Fax

Practice location:
  • Phone: 828-687-0088
  • Fax: 828-684-6693
Mailing address:
  • Phone: 828-687-5616
  • Fax: 828-650-8076

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberMD431809
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code207UN0901X
TaxonomyNuclear Cardiology Physician
License NumberMD431809
License Number StatePA
# 3
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number200001592
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: