Organization
KIM A HARDEY A PROFESSIONAL MEDICAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KIM ANTHONY HARDEY M.D. (PRESIDENT/OWNER)
(337) 261-5433
Entity
Organization
Contact information
Practice address
1211 COOLIDGE BLVD, SUITE 403, LAFAYETTE, LA 70503-2636
(337) 261-5433
(337) 269-9652
Mailing address
1211 COOLIDGE BLVD, SUITE 403, LAFAYETTE, LA 70503-2636
(337) 261-5433
(337) 269-9652
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
016206
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1345911
—
LA
Enumeration date
09/15/2010
Last updated
09/15/2010
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