Provider Demographics
NPI:1932166154
Name:HARDER, SCOTT N (DO)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:N
Last Name:HARDER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2820 OHIO ST
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:KS
Mailing Address - Zip Code:67010-2361
Mailing Address - Country:US
Mailing Address - Phone:316-775-7500
Mailing Address - Fax:316-775-3685
Practice Address - Street 1:2820 OHIO ST
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:KS
Practice Address - Zip Code:67010-2361
Practice Address - Country:US
Practice Address - Phone:316-775-7500
Practice Address - Fax:316-775-3685
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-01
Last Update Date:2023-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS0528837207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100369030-EMedicaid
KS102644OtherGROUP PTAN
KS200632830AMedicaid
KSH25439Medicare UPIN
KS102650Medicare PIN