Provider Demographics
NPI:1538144431
Name:HARDESTY, JAMES L (MD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:L
Last Name:HARDESTY
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 1:5W LINDEN DR
Mailing Address - Street 2:
Mailing Address - City:CARLISLE
Mailing Address - State:PA
Mailing Address - Zip Code:17015-6907
Mailing Address - Country:US
Mailing Address - Phone:717-245-9116
Mailing Address - Fax:717-243-1910
Practice Address - Street 1:366 ALEXANDER SPRING RD
Practice Address - Street 2:
Practice Address - City:CARLISLE
Practice Address - State:PA
Practice Address - Zip Code:17015-9167
Practice Address - Country:US
Practice Address - Phone:717-243-1900
Practice Address - Fax:717-243-1910
Is Sole Proprietor?:No
Enumeration Date:2005-12-13
Last Update Date:2015-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD039768L208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0011300820001Medicaid
50038539OtherCAP BLUE CROSS
170655OtherHIGHMARK BLUE SHIELD
PA170655Medicare PIN
170655OtherHIGHMARK BLUE SHIELD