Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 23875 | KY |
N | 111NI0900X | Internist | 23875 | KY |
Y | 207RA0401X | Internist - Addiction Medicine | 23875 | KY |
NPI | 1225039258 |
---|---|
Provider Name | Mr. Barry G Hardison |
First Address | Central City, KY 42330-1929 |
Second Address | Central City, KY 42330-1929 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/08/2005 |
Last Update Date | 12/10/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
64238751 | (05) | KY |
C69350 | (02) |