Provider Demographics
NPI:1801106984
Name:HARNER, CARON E (DPM)
Entity type:Individual
Prefix:DR
First Name:CARON
Middle Name:E
Last Name:HARNER
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 635283
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45263-5283
Mailing Address - Country:US
Mailing Address - Phone:859-212-0175
Mailing Address - Fax:859-441-3698
Practice Address - Street 1:525 ALEXANDRIA PIKE
Practice Address - Street 2:
Practice Address - City:SOUTHGATE
Practice Address - State:KY
Practice Address - Zip Code:41071-3290
Practice Address - Country:US
Practice Address - Phone:859-212-0175
Practice Address - Fax:859-441-3698
Is Sole Proprietor?:No
Enumeration Date:2010-10-07
Last Update Date:2024-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH36003589213E00000X
KY00386213E00000X
IN07001450A213E00000X
KY244164213ES0103X, 213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
No213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0062289Medicaid
KY7100189240Medicaid
OH0062289Medicaid
OHH079150Medicare PIN
KY7100189240Medicaid
KYK033070Medicare PIN