Provider Demographics
NPI:1316149578
Name:HARDY, WILLIAM MCDONALD JR (MSPA-C)
Entity type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:MCDONALD
Last Name:HARDY
Suffix:JR
Gender:M
Credentials:MSPA-C
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Mailing Address - Street 1:540 ANDERSON COUNTY ROAD 2139
Mailing Address - Street 2:
Mailing Address - City:PALESTINE
Mailing Address - State:TX
Mailing Address - Zip Code:75801
Mailing Address - Country:US
Mailing Address - Phone:903-731-4307
Mailing Address - Fax:903-731-4307
Practice Address - Street 1:PALESTINE REGIONAL MEDICAL CENTER
Practice Address - Street 2:2900 SOUTH LOOP 256
Practice Address - City:PALESTINE
Practice Address - State:TX
Practice Address - Zip Code:75801
Practice Address - Country:US
Practice Address - Phone:903-723-0911
Practice Address - Fax:903-723-0999
Is Sole Proprietor?:No
Enumeration Date:2007-06-01
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
TXPA01693363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant