Provider Demographics
NPI:1104869148
Name:HARDEMAN, NATASHA N (MD)
Entity type:Individual
Prefix:DR
First Name:NATASHA
Middle Name:N
Last Name:HARDEMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2506 LAKELAND DR STE 600
Mailing Address - Street 2:
Mailing Address - City:FLOWOOD
Mailing Address - State:MS
Mailing Address - Zip Code:39232-7640
Mailing Address - Country:US
Mailing Address - Phone:601-939-1600
Mailing Address - Fax:601-939-1606
Practice Address - Street 1:2506 LAKELAND DR STE 600
Practice Address - Street 2:
Practice Address - City:FLOWOOD
Practice Address - State:MS
Practice Address - Zip Code:39232-7640
Practice Address - Country:US
Practice Address - Phone:601-939-1600
Practice Address - Fax:601-939-1606
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2019-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS18064207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS07926573Medicaid
MS07926573Medicaid
MSH48450Medicare UPIN