Individual
MR. MYRON JEFFREY HARDESTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
7505 NEW LAGRANGE ROAD, LOUISVILLE, KY 40222
(502) 412-3232
(502) 412-3233
Mailing address
7505 NEW LAGRANGE ROAD, LOUISVILLE, KY 40222
(502) 412-3232
(502) 412-3233
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA1185
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11918387
CAQH
KY
Enumeration date
11/18/2008
Last updated
02/04/2013
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