Individual
PETER B HARDIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
125 GREENBRIAR DR, CAMPBELLSVILLE, KY 42718-9616
(270) 789-9999
(270) 789-0247
Mailing address
125 GREENBRIAR DR, CAMPBELLSVILLE, KY 42718-9616
(270) 789-9999
(270) 789-0247
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
42374
KY
2085R0001X
Radiation Oncology Physician
4301081290
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000664006
ANTHEM
—
05
—
104495980
—
MI
01
—
1366419814
TRICARE
—
01
—
50028881
PASSPORT HEALTH PLAN/PASSPORT ADVANTAGE
KY
05
—
7100060870
—
KY
01
—
C55045
CUMBERLAND HEALTHCARE
KY
Enumeration date
03/03/2006
Last updated
02/01/2017
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