Organization
JOHN T HARDY M.D. P.C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN TUCKER HARDY M.D. (PHYSICIAN)
(719) 583-4232
Entity
Organization
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
251S00000X
Community/Behavioral Health Agency
Primary
30618
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01-306182
—
CO
Enumeration date
06/29/2009
Last updated
06/29/2009
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