Provider Demographics
NPI:1558635748
Name:HARDER, CARL E (OD)
Entity Type:Individual
Prefix:DR
First Name:CARL
Middle Name:E
Last Name:HARDER
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:6420 DUTCHMANS PKWY
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40205-3372
Mailing Address - Country:US
Mailing Address - Phone:502-259-5026
Mailing Address - Fax:502-259-7393
Practice Address - Street 1:6420 DUTCHMANS PKWY
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40205-3372
Practice Address - Country:US
Practice Address - Phone:502-259-5026
Practice Address - Fax:502-259-7393
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-06
Last Update Date:2013-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN18003712A152W00000X
IN18003712B152W00000X
KY1894DT152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist