Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223X0400X | Orthodontists | 2960 | AL |
NPI | 1063668523 |
---|---|
Provider Name | Dr. Philip Carey Hardee |
First Address | Andalusia, AL 36420-1222 |
Second Address | Andalusia, AL 36420-4150 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/08/2008 |
Last Update Date | 14/08/2008 |