Provider Demographics
NPI:1164734125
Name:HARDIE, JAMES D (OD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:D
Last Name:HARDIE
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3309 QUAIL HOLLOW DR STE E
Mailing Address - Street 2:
Mailing Address - City:LAMBERTVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48144-8688
Mailing Address - Country:US
Mailing Address - Phone:734-854-3937
Mailing Address - Fax:734-854-5868
Practice Address - Street 1:3309 QUAIL HOLLOW DR STE E
Practice Address - Street 2:
Practice Address - City:LAMBERTVILLE
Practice Address - State:MI
Practice Address - Zip Code:48144-8688
Practice Address - Country:US
Practice Address - Phone:734-854-3937
Practice Address - Fax:734-854-5868
Is Sole Proprietor?:No
Enumeration Date:2010-07-07
Last Update Date:2010-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4901004590152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist