Individual
JOHN TUCKER HARDY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1115 N GRAND AVE, PUEBLO, CO 81003-2867
(719) 583-4232
(719) 562-4415
Mailing address
1115 N GRAND AVE, PUEBLO, CO 81003-2867
(719) 583-4232
(719) 562-4415
Taxonomy
Speciality
Code
Description
License number
State
2084F0202X
Forensic Psychiatry Physician
30618
CO
2084P0800X
Psychiatry Physician
Primary
30618
CO
2084P0804X
Child & Adolescent Psychiatry Physician
30618
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01-306182
—
CO
Enumeration date
12/26/2006
Last updated
01/11/2008
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