1669584819 NPI number — DR. MARK A HARDING MD

Table of content: DR. MARK A HARDING MD (NPI 1669584819)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1669584819 NPI number — DR. MARK A HARDING MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HARDING
Provider First Name:
MARK
Provider Middle Name:
A
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1669584819
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/26/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
237 WILLIAM HOWARD TAFT RD
Provider Second Line Business Mailing Address:
2ND FLOOR, CBO 2-3
Provider Business Mailing Address City Name:
CINCINNATI
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
45219-2610
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
513-541-0700
Provider Business Mailing Address Fax Number:
513-541-2530

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2123 AUBURN AVE
Provider Second Line Business Practice Location Address:
SU. 315
Provider Business Practice Location Address City Name:
CINCINNATI
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
45219-2906
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
513-541-0700
Provider Business Practice Location Address Fax Number:
513-541-2530
Provider Enumeration Date:
08/31/2006

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: 2086S0129X , with the licence number:  41441 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2086S0129X , with the licence number: 89902 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 7100056850 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 200870910 . This is a "IN MEDICAID" identifier , issued by the state of ( IN ) . This identifiers is of the category "OTHER".
  • Identifier: 200870910A , issued by the state of ( IN ) . This identifiers is of the category "MEDICAID".
  • Identifier: P00469075 . This is a "RAIL ROAD MEDICARE" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 7100020200 . This is a "KY MEDICAID" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 7100020200 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 2779542 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: P00689755 . This is a "RAILROAD MEDICARE KY" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".




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