Provider Demographics
NPI:1952308769
Name:HARDCASTLE, RICHARD LOWELL (MD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:LOWELL
Last Name:HARDCASTLE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1000 W KINGSHIGHWAY
Mailing Address - Street 2:STE 5
Mailing Address - City:PARAGOULD
Mailing Address - State:AR
Mailing Address - Zip Code:72450-4141
Mailing Address - Country:US
Mailing Address - Phone:870-236-6948
Mailing Address - Fax:870-236-7024
Practice Address - Street 1:1000 W KINGSHIGHWAY
Practice Address - Street 2:STE 5
Practice Address - City:PARAGOULD
Practice Address - State:AR
Practice Address - Zip Code:72450-4141
Practice Address - Country:US
Practice Address - Phone:870-236-6948
Practice Address - Fax:870-236-7024
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-07
Last Update Date:2007-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARR-2493207W00000X
MOMD105325207W00000X
TXE1330207W00000X
CAA24052207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
5B035Medicare ID - Type Unspecified
B90259Medicare UPIN