Provider Demographics
NPI:1497723290
Name:HARDING, MICHAEL O'CONNOR (DO)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:O'CONNOR
Last Name:HARDING
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 518
Mailing Address - Street 2:
Mailing Address - City:ARDMORE
Mailing Address - State:OK
Mailing Address - Zip Code:73402-0518
Mailing Address - Country:US
Mailing Address - Phone:580-220-6687
Mailing Address - Fax:580-223-6285
Practice Address - Street 1:815 PENNSYLVANIA AVE
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76104-2224
Practice Address - Country:US
Practice Address - Phone:817-321-0312
Practice Address - Fax:817-317-7033
Is Sole Proprietor?:No
Enumeration Date:2006-03-09
Last Update Date:2023-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL16022085R0202X, 2085N0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085N0700XAllopathic & Osteopathic PhysiciansRadiologyNeuroradiology
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX145958810Medicaid
TX145958808Medicaid
TX145958808Medicaid
TXE43276Medicare UPIN
TX145958810Medicaid