Provider Demographics
NPI:1033119268
Name:JONES HARDESTY, KATHERINE E (OD)
Entity Type:Individual
Prefix:DR
First Name:KATHERINE
Middle Name:E
Last Name:JONES HARDESTY
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1484 N GREEN RIVER RD
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47715-2429
Mailing Address - Country:US
Mailing Address - Phone:812-477-0623
Mailing Address - Fax:812-473-5653
Practice Address - Street 1:1484 N GREEN RIVER RD
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47715-2429
Practice Address - Country:US
Practice Address - Phone:812-477-0623
Practice Address - Fax:812-473-5653
Is Sole Proprietor?:No
Enumeration Date:2005-07-29
Last Update Date:2011-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN18001910B152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN410040006OtherRR MEDICARE
IN100101220AMedicaid
IN11051OtherSPECTERA
ININ1910OtherEYEMED
IN000000085303OtherANTHEM
IN444457OtherHIGHMARK
INU10020Medicare UPIN
IN533160BMedicare PIN