Provider Demographics
NPI:1083042170
Name:HARDIN, BRANDON (DC)
Entity Type:Individual
Prefix:DR
First Name:BRANDON
Middle Name:
Last Name:HARDIN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:370 COURTHOUSE RD
Mailing Address - Street 2:101
Mailing Address - City:GULFPORT
Mailing Address - State:MS
Mailing Address - Zip Code:39507-1889
Mailing Address - Country:US
Mailing Address - Phone:228-241-1000
Mailing Address - Fax:
Practice Address - Street 1:370 COURTHOUSE RD
Practice Address - Street 2:101
Practice Address - City:GULFPORT
Practice Address - State:MS
Practice Address - Zip Code:39507-1889
Practice Address - Country:US
Practice Address - Phone:228-241-1000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-29
Last Update Date:2014-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12463111N00000X
MS1219111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor