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NPI Code Detail

MEDICARE: WILLIE HARDY JR. MD

MEDICARE: WILLIE HARDY JR. MD
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
1207L00000XAnesthesiology PhysicianMD035425EPA

General Provider Information

NPI Number : 1457340572
Entity Type Code : Individual
Provider Name (Legal Business Name) : WILLIE HARDY JR. MD
Provider Business Mailing Address
First Line : PO BOX 1005
Second Line :
City : EDGEMONT
State : PA
Zip : 19028-1005
Country : US
Telephone Number : 610-450-4559
Fax Number : 610-596-0255
Provider Business Practice Location Address
First Line : 300 HIGHLAND AVE
Second Line :
City : HANOVER
State : PA
Zip : 17331-2297
Country : US
Telephone Number : 814-877-6000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/20/2005
Last Update Date : 01/30/2025

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