1891746541 NPI number — GREGORY P. HARDERS MD

Table of content: GREGORY P. HARDERS MD (NPI 1891746541)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1891746541 NPI number — GREGORY P. HARDERS MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HARDERS
Provider First Name:
GREGORY
Provider Middle Name:
P.
Provider Name Prefix Text:
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:
1891746541
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/03/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
ONE VANTAGEWAY, SUITE B240
Provider Second Line Business Mailing Address:
MIDDLE TENNESSEE EMERGENCY PHYSICIANS, PC
Provider Business Mailing Address City Name:
NASHVILLE
Provider Business Mailing Address State Name:
TN
Provider Business Mailing Address Postal Code:
37228-1562
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
615-329-4020
Provider Business Mailing Address Fax Number:
615-327-5475

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3100 TONGASS AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KETCHIKAN
Provider Business Practice Location Address State Name:
AK
Provider Business Practice Location Address Postal Code:
99901-5746
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
907-225-5171
Provider Business Practice Location Address Fax Number:
907-370-2533
Provider Enumeration Date:
05/15/2006

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: 146D00000X , with the licence number:  28351 , registered in the state of AZ ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207P00000X , with the licence number: 52680 , registered in the state of TN ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207P00000X , with the licence number: 214852 , registered in the state of AK ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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