Provider Demographics
NPI:1679710503
Name:JAMES C. HARKRADER MD, PC
Entity Type:Organization
Organization Name:JAMES C. HARKRADER MD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:COLLIN
Authorized Official - Last Name:HARKRADER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:804-747-7425
Mailing Address - Street 1:2821 N. PARHAM RD.
Mailing Address - Street 2:STE. 105
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23294
Mailing Address - Country:US
Mailing Address - Phone:804-747-7425
Mailing Address - Fax:804-346-9390
Practice Address - Street 1:2821 N PARHAM RD
Practice Address - Street 2:105
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23294-4412
Practice Address - Country:US
Practice Address - Phone:804-747-6966
Practice Address - Fax:804-346-9390
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-14
Last Update Date:2009-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101019265174400000X, 207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty
No174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA6305610Medicaid
VA182930356Medicare PIN
VAB06156Medicare UPIN