Provider Demographics
NPI:1841546629
Name:HARDER, TIFFANY ANN (OD)
Entity type:Individual
Prefix:DR
First Name:TIFFANY
Middle Name:ANN
Last Name:HARDER
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:TIFFANY
Other - Middle Name:ANN
Other - Last Name:ADKINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:1643 AIKEN RD
Mailing Address - Street 2:
Mailing Address - City:SHELBYVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40065-9704
Mailing Address - Country:US
Mailing Address - Phone:606-776-8782
Mailing Address - Fax:
Practice Address - Street 1:7635 SHELBYVILLE RD
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40222-5409
Practice Address - Country:US
Practice Address - Phone:502-371-4904
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-30
Last Update Date:2016-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1889DT152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist