Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223S0112X | Oral and Maxillofacial Surgeon | DN 12910 | FL |
N | 204E00000X | Oral & Maxillofacial Surgeon | ME59580 | FL |
NPI | 1447343918 |
---|---|
Provider Name | Dr. John Howard Hardeman |
First Address | Gainesville, FL 32610-0405 |
Second Address | Gainesville, FL 32610-0405 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/10/2006 |
Last Update Date | 17/11/2014 |