Provider Demographics
NPI:1356558498
Name:LARDY, DIANA ELIZABETH (MD)
Entity type:Individual
Prefix:DR
First Name:DIANA
Middle Name:ELIZABETH
Last Name:LARDY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3902 MEYER AVE
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53711-1617
Mailing Address - Country:US
Mailing Address - Phone:608-238-9165
Mailing Address - Fax:
Practice Address - Street 1:3706 ORIN RD
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53704-3643
Practice Address - Country:US
Practice Address - Phone:608-251-7000
Practice Address - Fax:608-241-3854
Is Sole Proprietor?:No
Enumeration Date:2007-05-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI21756-020207QH0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QH0002XAllopathic & Osteopathic PhysiciansFamily MedicineHospice and Palliative Medicine