Provider Demographics
NPI:1891730339
Name:HARDER FAMILY PRACTICE,PA
Entity Type:Organization
Organization Name:HARDER FAMILY PRACTICE,PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:N
Authorized Official - Last Name:HARDER
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:316-775-7500
Mailing Address - Street 1:2820 OHIO ST
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:KS
Mailing Address - Zip Code:67010-2361
Mailing Address - Country:US
Mailing Address - Phone:316-775-7500
Mailing Address - Fax:316-775-3685
Practice Address - Street 1:2820 OHIO ST
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:KS
Practice Address - Zip Code:67010-2361
Practice Address - Country:US
Practice Address - Phone:316-775-7500
Practice Address - Fax:316-775-3685
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-18
Last Update Date:2023-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS05-28837207Q00000X
363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS17D1008887OtherCLIA
KS201308970AMedicaid