Provider Demographics
NPI:1245836212
Name:HARDIN, CHARLES ANDERSON III (MED)
Entity type:Individual
Prefix:MR
First Name:CHARLES
Middle Name:ANDERSON
Last Name:HARDIN
Suffix:III
Gender:M
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:808 WOODLAND VLG
Mailing Address - Street 2:
Mailing Address - City:VESTAVIA HILLS
Mailing Address - State:AL
Mailing Address - Zip Code:35216-1120
Mailing Address - Country:US
Mailing Address - Phone:205-792-0871
Mailing Address - Fax:
Practice Address - Street 1:4 OFFICE PARK CIR
Practice Address - Street 2:
Practice Address - City:MOUNTAIN BRK
Practice Address - State:AL
Practice Address - Zip Code:35223-2511
Practice Address - Country:US
Practice Address - Phone:256-954-5009
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-07
Last Update Date:2023-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALLPC04880101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health