Provider Demographics
NPI:1487251575
Name:HARDWICK, RONALD MESHA JR
Entity type:Individual
Prefix:MR
First Name:RONALD
Middle Name:MESHA
Last Name:HARDWICK
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1226 EDER LN
Mailing Address - Street 2:
Mailing Address - City:WEST BEND
Mailing Address - State:WI
Mailing Address - Zip Code:53095-4967
Mailing Address - Country:US
Mailing Address - Phone:813-679-5082
Mailing Address - Fax:
Practice Address - Street 1:1226 EDER LN
Practice Address - Street 2:
Practice Address - City:WEST BEND
Practice Address - State:WI
Practice Address - Zip Code:53095-4967
Practice Address - Country:US
Practice Address - Phone:813-679-5082
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-02
Last Update Date:2024-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX146N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes146N00000XEmergency Medical Service ProvidersEmergency Medical Technician, Basic