Individual
ROBERT DAMION HARDISON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
55 FOUNDATION DR, FLEMINGSBURG, KY 41041-9815
(606) 849-5000
Mailing address
9405 LOMAX FOREST DR, MANASSAS, VA 20112-4448
(703) 615-4141
(844) 605-4187
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
0101251662
VA
207P00000X
Emergency Medicine Physician
25483
WV
207P00000X
Emergency Medicine Physician
46459
KY
207Q00000X
Family Medicine Physician
0101251662
VA
207Q00000X
Family Medicine Physician
MD36862
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3880452
—
TN
Enumeration date
08/09/2005
Last updated
08/23/2021
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