Provider Demographics
NPI:1316486814
Name:HARDIN, JOSIAH (DO)
Entity type:Individual
Prefix:DR
First Name:JOSIAH
Middle Name:
Last Name:HARDIN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:49 MDG 280 DAVID L. GOLDFEIN STREET
Mailing Address - Street 2:BLDG 23
Mailing Address - City:HOLLOMAN AFB
Mailing Address - State:NM
Mailing Address - Zip Code:88310
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:49 MDG 280 DAVID L GOLDFEIN ST
Practice Address - Street 2:BLDG 23
Practice Address - City:HOLLOMAN AFB
Practice Address - State:NM
Practice Address - Zip Code:88330
Practice Address - Country:US
Practice Address - Phone:575-572-2778
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-16
Last Update Date:2024-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0102205419207R00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine