Provider Demographics
NPI:1023247509
Name:HARDY, RACHEL TENNESSEE (DO)
Entity type:Individual
Prefix:DR
First Name:RACHEL
Middle Name:TENNESSEE
Last Name:HARDY
Suffix:
Gender:F
Credentials:DO
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Mailing Address - Street 1:1260 S CAMPBELL AVE
Mailing Address - Street 2:
Mailing Address - City:GREEN VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:85614-0503
Mailing Address - Country:US
Mailing Address - Phone:520-407-5600
Mailing Address - Fax:520-625-8504
Practice Address - Street 1:18857 S LA CANADA DR
Practice Address - Street 2:
Practice Address - City:SAHUARITA
Practice Address - State:AZ
Practice Address - Zip Code:85629-7990
Practice Address - Country:US
Practice Address - Phone:520-407-5800
Practice Address - Fax:520-407-5990
Is Sole Proprietor?:No
Enumeration Date:2009-07-06
Last Update Date:2024-12-31
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AZ005626208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ154614Medicaid