Provider Demographics
NPI:1174691877
Name:HARDY, JON TAYLOR (PT, MS)
Entity type:Individual
Prefix:MR
First Name:JON
Middle Name:TAYLOR
Last Name:HARDY
Suffix:
Gender:M
Credentials:PT, MS
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Other - Credentials:
Mailing Address - Street 1:307 CARPENTER DAM RD
Mailing Address - Street 2:SUITE L
Mailing Address - City:HOT SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:71901-8218
Mailing Address - Country:US
Mailing Address - Phone:501-623-6353
Mailing Address - Fax:501-321-4783
Practice Address - Street 1:307 CARPENTER DAM RD
Practice Address - Street 2:SUITE L
Practice Address - City:HOT SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:71901-8218
Practice Address - Country:US
Practice Address - Phone:501-623-6353
Practice Address - Fax:501-321-4783
Is Sole Proprietor?:No
Enumeration Date:2006-12-01
Last Update Date:2015-10-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AR1481225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ARQ10814Medicare UPIN
AR5C316Medicare ID - Type Unspecified