Provider Demographics
NPI:1295368900
Name:HARDEMAN, DORIS HUFF
Entity Type:Individual
Prefix:
First Name:DORIS
Middle Name:HUFF
Last Name:HARDEMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:75 ROLLING RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:GA
Mailing Address - Zip Code:30016-1823
Mailing Address - Country:US
Mailing Address - Phone:770-784-0258
Mailing Address - Fax:
Practice Address - Street 1:75 ROLLING RIDGE DR
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:GA
Practice Address - Zip Code:30016-1823
Practice Address - Country:US
Practice Address - Phone:770-784-0258
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-20
Last Update Date:2020-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1744P3200XOther Service ProvidersSpecialistProsthetics Case Management