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NPI Code Detail

MEDICARE: MR. BARRY G HARDISON MD, FASAM

MEDICARE: MR. BARRY G HARDISON MD, FASAM
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine Physician23875KY
2207RA0401XAddiction Medicine (Internal Medicine) Physician23875KY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1225039258
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. BARRY G HARDISON MD, FASAM
Provider Business Mailing Address
First Line : 222 PHILLIP STONE WAY
Second Line :
City : CENTRAL CITY
State : KY
Zip : 42330-1929
Country : US
Telephone Number : 270-754-3494
Fax Number : 270-377-1683
Provider Business Practice Location Address
First Line : 222 PHILLIP STONE WAY
Second Line :
City : CENTRAL CITY
State : KY
Zip : 42330-1929
Country : US
Telephone Number : 270-754-3494
Fax Number : 270-754-3499
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/01/2005
Last Update Date : 10/20/2022

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