Provider Demographics
NPI:1750463642
Name:HARDMAN, VAN (OD)
Entity Type:Individual
Prefix:DR
First Name:VAN
Middle Name:
Last Name:HARDMAN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:981 HUNTINGTON CIR NW
Mailing Address - Street 2:
Mailing Address - City:ARAB
Mailing Address - State:AL
Mailing Address - Zip Code:35016-1929
Mailing Address - Country:US
Mailing Address - Phone:256-586-1845
Mailing Address - Fax:
Practice Address - Street 1:981 HUNTINGTON CIR NW
Practice Address - Street 2:
Practice Address - City:ARAB
Practice Address - State:AL
Practice Address - Zip Code:35016-1929
Practice Address - Country:US
Practice Address - Phone:256-586-1845
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALS-625-TA-430152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51045023HAROtherBLUE CROSS NUMBER