Basic Information
| Provider Information | |||||||||
| NPI: | 1235323551 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | WILLIAM R HARDCASTLE MD PC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3525 PIEDMONT RD NE | ||||||||
| Address2: | BLDG 7-601 | ||||||||
| City: | ATLANTA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 303051578 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4048425400 | ||||||||
| FaxNumber: | 4048481213 | ||||||||
| Practice Location | |||||||||
| Address1: | 487 WINN WAY STE 103 | ||||||||
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| City: | DECATUR | ||||||||
| State: | GA | ||||||||
| PostalCode: | 300301700 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4042960148 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/29/2007 | ||||||||
| LastUpdateDate: | 05/17/2010 | ||||||||
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| AuthorizedOfficialLastName: | HARDCASTLE | ||||||||
| AuthorizedOfficialFirstName: | WILLIAM | ||||||||
| AuthorizedOfficialMiddleName: | R | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 4042960148 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208600000X | 12914 | GA | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Surgery |
No ID Information.