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General NPI Number Information
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NPI Number | 1457340572
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Entity Type | Individual
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Provider Name | WILLIE HARDY JR. MD
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Gender | Male
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Dates
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Enumeration Date | 10/20/2005
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Last Update Date | 01/30/2025
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Provider Practice Location Address
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Address Line | 300 HIGHLAND AVE
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City | HANOVER
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State | PA
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Zip | 17331-2297
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Country | US
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Telephone | 814-877-6000
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1005
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City | EDGEMONT
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State | PA
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Zip | 19028-1005
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Country | US
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Telephone | 610-450-4559
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Fax | 610-596-0255
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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 | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | MD035425E
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License Number State | PA
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