Provider Demographics
NPI:1215058284
Name:HARDIN, AUTUMN SHAFFER (MD)
Entity type:Individual
Prefix:
First Name:AUTUMN
Middle Name:SHAFFER
Last Name:HARDIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:612 ATKINS RD
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72211-3335
Mailing Address - Country:US
Mailing Address - Phone:501-580-2268
Mailing Address - Fax:
Practice Address - Street 1:612 ATKINS RD
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72211-3335
Practice Address - Country:US
Practice Address - Phone:501-580-2268
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-03
Last Update Date:2010-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE-6185207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology