Provider Demographics
NPI:1982791729
Name:HARDY, ROBERT ORGAIN (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:ORGAIN
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 1:600 WAYNE AV
Mailing Address - Street 2:EASTWAY BEHAVIORAL HEALTHCARE
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45410-1122
Mailing Address - Country:US
Mailing Address - Phone:937-496-2000
Mailing Address - Fax:937-463-2905
Practice Address - Street 1:600 WAYNE AV
Practice Address - Street 2:EASTWAY BEHAVIORAL HEALTHCARE
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45410-1122
Practice Address - Country:US
Practice Address - Phone:937-496-2000
Practice Address - Fax:937-463-2905
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2017-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS163282084P0800X
OH35.0701282084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS00120586Medicaid
MS0120586Medicaid
MS0120586Medicaid
MS260000434Medicare ID - Type UnspecifiedMEDICARE PROVIDER
MS00120586Medicaid