=====================================================
General NPI Number Information
=====================================================
NPI Number | 1669584819
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MARK A HARDING MD
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/31/2006
-----------------------------------------------------
Last Update Date | 10/26/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2123 AUBURN AVE SU. 315
-----------------------------------------------------
City | CINCINNATI
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 45219-2906
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 513-541-0700
-----------------------------------------------------
Fax | 513-541-2530
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 237 WILLIAM HOWARD TAFT RD 2ND FLOOR, CBO 2-3
-----------------------------------------------------
City | CINCINNATI
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 45219-2610
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 513-541-0700
-----------------------------------------------------
Fax | 513-541-2530
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 2086S0129X
-----------------------------------------------------
Taxonomy Name | Vascular Surgery Physician
-----------------------------------------------------
License Number | 41441
-----------------------------------------------------
License Number State | KY
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 2086S0129X
-----------------------------------------------------
Taxonomy Name | Vascular Surgery Physician
-----------------------------------------------------
License Number | 89902
-----------------------------------------------------
License Number State | OH
-----------------------------------------------------