1407103872 NPI number — MR. WES JAMES HARDCASTLE-ORR M.S.W.

Table of content: MR. WES JAMES HARDCASTLE-ORR M.S.W. (NPI 1407103872)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1407103872 NPI number — MR. WES JAMES HARDCASTLE-ORR M.S.W.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HARDCASTLE-ORR
Provider First Name:
WES
Provider Middle Name:
JAMES
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
M.S.W.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
ORR
Provider Other First Name:
WES
Provider Other Middle Name:
JAMES
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
M.S.W.
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1407103872
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/28/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
21 COVE CT
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SAVANNAH
Provider Business Mailing Address State Name:
GA
Provider Business Mailing Address Postal Code:
31419-9384
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
912-695-7863
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
513 E OGLETHORPE AVE STE F
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SAVANNAH
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
31401-4141
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
912-208-9850
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/05/2012

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YA0400X , with the licence number:  6801080076 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 101YM0800X , with the licence number: 6801080076 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 1041C0700X , with the licence number: 6801080076 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 1041C0700X , with the licence number: CSW006688 , registered in the state of GA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)