Basic Information
Provider Information
NPI: 1710913033
EntityType: 2
ReplacementNPI:  
OrganizationName: HARDIN PHYSICIAN FOUNDATION INC.
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Mailing Information
Address1: L 3309
Address2:  
City: COLUMBUS
State: OH
PostalCode: 432600001
CountryCode: US
TelephoneNumber: 8005144390
FaxNumber:  
Practice Location
Address1: 921 E FRANKLIN ST
Address2:  
City: KENTON
State: OH
PostalCode: 433262020
CountryCode: US
TelephoneNumber: 4196730761
FaxNumber:  
Other Information
ProviderEnumerationDate: 06/26/2006
LastUpdateDate: 07/21/2022
NPIDeactivationReasonCode:  
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AuthorizedOfficialLastName: SECKINGER
AuthorizedOfficialFirstName: MARK
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AuthorizedOfficialTitleorPosition: SECRETARY
AuthorizedOfficialTelephone: 4196758318
IsSoleProprietor:  
IsOrganizationSubpart: N
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Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208600000X OHN193200000X MULTI-SPECIALTY GROUPAllopathic & Osteopathic PhysiciansSurgery 
208D00000X34008871OHN193200000X MULTI-SPECIALTY GROUPAllopathic & Osteopathic PhysiciansGeneral Practice 
207R00000X35075560OHY193200000X MULTI-SPECIALTY GROUPAllopathic & Osteopathic PhysiciansInternal Medicine 

ID Information
IDTypeStateIssuerDescription
CH926401 RAILROAD MEDICAREOTHER
200381605OH MEDICAID


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