Provider Demographics
NPI:1184626632
Name:HARDY, JOSEPH PAUL (MD)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:PAUL
Last Name:HARDY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:874 AMERICAN PACIFIC DR
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89014-8800
Mailing Address - Country:US
Mailing Address - Phone:702-777-4809
Mailing Address - Fax:
Practice Address - Street 1:595 W LAKE MEAD PKWY
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89015-7015
Practice Address - Country:US
Practice Address - Phone:702-566-5500
Practice Address - Fax:702-558-7237
Is Sole Proprietor?:No
Enumeration Date:2005-08-15
Last Update Date:2019-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV4506207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1184626632Medicaid
NVP00827599OtherRAILROAD MEDICARE
NV1184626632Medicaid