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General NPI Number Information
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NPI Number | 1790788826
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Entity Type | Individual
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Provider Name | PATRICK JOHN HARDIMAN DPM
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Gender | Male
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Dates
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Enumeration Date | 05/23/2005
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Last Update Date | 08/25/2020
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Provider Practice Location Address
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Address Line | 500 E VETERANS ST
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City | TOMAH
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State | WI
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Zip | 54660-3105
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Country | US
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Telephone | 608-372-3971
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Fax |
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Provider Business Mailing Address
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Address Line | 311 8TH ST S
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City | WISCONSIN RAPIDS
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State | WI
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Zip | 54494-4622
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Country | US
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Telephone | 715-423-8637
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Fax | 715-424-2724
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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 | 213ES0131X
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Taxonomy Name | Foot Surgery Podiatrist
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License Number | 678-025
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | 678-025
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License Number State | WI
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