Provider Demographics
NPI:1699044024
Name:HARDMAN, KARL GRANT
Entity Type:Individual
Prefix:
First Name:KARL
Middle Name:GRANT
Last Name:HARDMAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11440 E 61ST PL
Mailing Address - Street 2:
Mailing Address - City:BROKEN ARROW
Mailing Address - State:OK
Mailing Address - Zip Code:74012-1225
Mailing Address - Country:US
Mailing Address - Phone:918-859-6691
Mailing Address - Fax:
Practice Address - Street 1:6202 S LEWIS AVE STE H
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74136-1064
Practice Address - Country:US
Practice Address - Phone:918-949-4086
Practice Address - Fax:918-949-3638
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-13
Last Update Date:2011-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor