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General NPI Number Information
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NPI Number | 1073801148
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Entity Type | Individual
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Provider Name | JOHN GEORGE HARDIE MD
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Gender | Male
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Dates
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Enumeration Date | 07/11/2011
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Last Update Date | 11/10/2020
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Provider Practice Location Address
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Address Line | 1111 DUFF AVENUE
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City | AMES
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State | IA
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Zip | 50010-3014
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Country | US
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Telephone | 515-239-2411
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Fax | 515-956-2714
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Provider Business Mailing Address
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Address Line | PO BOX 3014 1215 DUFF AVENUE
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City | AMES
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State | IA
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Zip | 50010-3014
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Country | US
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Telephone | 515-239-2411
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Fax | 515-956-2714
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0001X
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Taxonomy Name | Radiation Oncology Physician
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License Number | 55643
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License Number State | MN
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Taxonomy #2
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Taxonomy Code | 2085R0001X
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Taxonomy Name | Radiation Oncology Physician
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License Number | 106355
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License Number State | MN
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Taxonomy #3
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Taxonomy Code | 2085R0001X
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Taxonomy Name | Radiation Oncology Physician
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License Number | 43526
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License Number State | IA
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