MEDICARE: DR. DAVID HARDY M.D.

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
1	208600000X	Surgery Physician	121012	OH
2	208600000X	Surgery Physician	002507	GA
3	2086S0129X	Vascular Surgery Physician	121012	OH
4	2086S0129X	Vascular Surgery Physician	002507	GA

General Provider Information

NPI Number	:	1548467939
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID HARDY M.D.

Provider Business Mailing Address
First Line	:	9500 EUCLID AVE # F30
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44195-0001
Country	:	US
Telephone Number	:	216-444-6283
Fax Number	:

Provider Business Practice Location Address
First Line	:	2409 N PATTERSON ST STE 230
Second Line	:
City	:	VALDOSTA
State	:	GA
Zip	:	31602-2512
Country	:	US
Telephone Number	:	229-259-4369
Fax Number	:	229-259-4370

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/28/2007
Last Update Date	:	07/12/2021

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Directions to “ DR. DAVID HARDY M.D.” Practice Location

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