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Individual

JEFFREY C. HARDEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
1 CROWN DR, SUITE 104, KIRKSVILLE, MO 63501-2510
(660) 665-7500
(660) 665-7546
Mailing address
1 CROWN DR, SUITE 104, KIRKSVILLE, MO 63501-2510
(660) 665-7500
(660) 665-7546

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
R6D63
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000005781
GATEWAY EDI
MO
05
242657500
MO
01
431554537-63501
CHAMPUS
MO
01
BLUE CROSS/BLUE SHIE
13044
MO
Enumeration date
03/14/2006
Last updated
01/10/2013
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