Provider Demographics
NPI:1306473178
Name:HARDIE, LAKOTAH DOIG (MD)
Entity type:Individual
Prefix:
First Name:LAKOTAH
Middle Name:DOIG
Last Name:HARDIE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:LAKOTAH
Other - Middle Name:DAWN
Other - Last Name:DOIG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:922 S DEARBORN WAY
Mailing Address - Street 2:APT 11
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80012
Mailing Address - Country:US
Mailing Address - Phone:970-471-6307
Mailing Address - Fax:
Practice Address - Street 1:55 FRUIT ST
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114-2696
Practice Address - Country:US
Practice Address - Phone:617-894-1861
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-23
Last Update Date:2020-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program