MEDICARE: DR. PATRICK JOHN HARDIMAN DPM

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	213ES0131X	Foot Surgery Podiatrist	678-025	WI
2	213E00000X	Podiatrist	678-025	WI

Other Identifiers

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

General Provider Information

NPI Number	:	1790788826
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PATRICK JOHN HARDIMAN DPM

Provider Business Mailing Address
First Line	:	311 8TH ST S
Second Line	:
City	:	WISCONSIN RAPIDS
State	:	WI
Zip	:	54494-4622
Country	:	US
Telephone Number	:	715-423-8637
Fax Number	:	715-424-2724

Provider Business Practice Location Address
First Line	:	500 E VETERANS ST
Second Line	:
City	:	TOMAH
State	:	WI
Zip	:	54660-3105
Country	:	US
Telephone Number	:	608-372-3971
Fax Number	:

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

Provider Enumeration Date	:	05/23/2005
Last Update Date	:	08/25/2020

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