Provider Demographics
NPI:1790738318
Name:HARDISON, JOSHUA LEE (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:LEE
Last Name:HARDISON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:120 CONNER DR
Mailing Address - Street 2:STE 101
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27514
Mailing Address - Country:US
Mailing Address - Phone:919-942-8571
Mailing Address - Fax:919-942-6355
Practice Address - Street 1:120 CONNER DR
Practice Address - Street 2:STE 101
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27514
Practice Address - Country:US
Practice Address - Phone:919-942-8571
Practice Address - Fax:919-942-6355
Is Sole Proprietor?:No
Enumeration Date:2006-05-17
Last Update Date:2014-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200200541207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC891317YMedicaid
NC1317YOtherBCBS
NC420139OtherWELLPATH
NC187280OtherMEDCOST
NC562142486OtherBEECHSTREET
NC701891OtherUHC
NC2001322BOtherMEDICARE PDC
NC1242321OtherAETNA
NC7918115OtherCIGNA
2001322Medicare ID - Type Unspecified
NC1242321OtherAETNA