Provider Demographics
NPI:1033250709
Name:LIZABETH M HARDEN MD PC
Entity Type:Organization
Organization Name:LIZABETH M HARDEN MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LIZABETH
Authorized Official - Middle Name:MAYA
Authorized Official - Last Name:HARDEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:256-551-6526
Mailing Address - Street 1:201 SIVLEY RD SW
Mailing Address - Street 2:SUITE 550
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35801-5134
Mailing Address - Country:US
Mailing Address - Phone:256-551-6526
Mailing Address - Fax:256-551-6529
Practice Address - Street 1:201 SIVLEY RD SW
Practice Address - Street 2:SUITE 550
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-5134
Practice Address - Country:US
Practice Address - Phone:256-551-6526
Practice Address - Fax:256-551-6529
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL00011312207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1043283278OtherINDIVIDUAL NPI
ALC73435Medicare UPIN