Provider Demographics
NPI:1164557575
Name:HARDACRE, SUZANNE RUTH (MD)
Entity Type:Individual
Prefix:DR
First Name:SUZANNE
Middle Name:RUTH
Last Name:HARDACRE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 N LOCUST ST STE D
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:OH
Mailing Address - Zip Code:45056-1182
Mailing Address - Country:US
Mailing Address - Phone:513-523-2340
Mailing Address - Fax:513-523-5080
Practice Address - Street 1:10 N LOCUST ST STE D
Practice Address - Street 2:
Practice Address - City:OXFORD
Practice Address - State:OH
Practice Address - Zip Code:45056-1182
Practice Address - Country:US
Practice Address - Phone:513-523-2340
Practice Address - Fax:513-523-5080
Is Sole Proprietor?:No
Enumeration Date:2007-02-23
Last Update Date:2022-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35090660207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2925688Medicaid
OHH227881Medicare PIN
OH2925688Medicaid