Provider Demographics
NPI:1811201064
Name:HARDY, ANDREW BRADFORD (HIS)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:BRADFORD
Last Name:HARDY
Suffix:
Gender:M
Credentials:HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:888 COUNTY ROAD 115
Mailing Address - Street 2:
Mailing Address - City:NEW ALBANY
Mailing Address - State:MS
Mailing Address - Zip Code:38652-9518
Mailing Address - Country:US
Mailing Address - Phone:731-668-3165
Mailing Address - Fax:731-668-3165
Practice Address - Street 1:1001 BARNES CROSSING RD
Practice Address - Street 2:
Practice Address - City:TUPELO
Practice Address - State:MS
Practice Address - Zip Code:38804-0916
Practice Address - Country:US
Practice Address - Phone:662-840-3977
Practice Address - Fax:662-840-3977
Is Sole Proprietor?:No
Enumeration Date:2010-07-29
Last Update Date:2010-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS557237700000X
TN720237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist