Individual
JOHN GEORGE HARDIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1111 DUFF AVENUE, AMES, IA 50010-3014
(515) 239-2411
(515) 956-2714
Mailing address
PO BOX 3014, 1215 DUFF AVENUE, AMES, IA 50010-3014
(515) 239-2411
(515) 956-2714
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
106355
MN
2085R0001X
Radiation Oncology Physician
Primary
43526
IA
2085R0001X
Radiation Oncology Physician
55643
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ENROLLED
—
IA
05
—
ENROLLED
—
MN
Enumeration date
07/11/2011
Last updated
11/10/2020
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