Basic Information
| Provider Information | |||||||||
| NPI: | 1669584819 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HARDING | ||||||||
| FirstName: | MARK | ||||||||
| MiddleName: | A | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 237 WILLIAM HOWARD TAFT RD | ||||||||
| Address2: | 2ND FLOOR, CBO 2-3 | ||||||||
| City: | CINCINNATI | ||||||||
| State: | OH | ||||||||
| PostalCode: | 452192610 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5135410700 | ||||||||
| FaxNumber: | 5135412530 | ||||||||
| Practice Location | |||||||||
| Address1: | 2123 AUBURN AVE | ||||||||
| Address2: | SU. 315 | ||||||||
| City: | CINCINNATI | ||||||||
| State: | OH | ||||||||
| PostalCode: | 452192906 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5135410700 | ||||||||
| FaxNumber: | 5135412530 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/31/2006 | ||||||||
| LastUpdateDate: | 10/26/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/26/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2086S0129X | 41441 | KY | N | Allopathic & Osteopathic Physicians | Surgery | Vascular Surgery | 2086S0129X | 89902 | OH | Y | Allopathic & Osteopathic Physicians | Surgery | Vascular Surgery |
ID Information
| ID | Type | State | Issuer | Description | 7100056850 | 05 | KY | MEDICAID | 200870910 | 01 | IN | IN MEDICAID | OTHER | 200870910A | 05 | IN | MEDICAID | P00469075 | 01 | OH | RAIL ROAD MEDICARE | OTHER | 7100020200 | 01 | KY | KY MEDICAID | OTHER | 7100020200 | 05 | KY | MEDICAID | 2779542 | 05 | OH | MEDICAID | P00689755 | 01 | KY | RAILROAD MEDICARE KY | OTHER |