Provider Demographics
NPI:1487896973
Name:HARDEE, MATTHEW EMERY (MD, PHD)
Entity type:Individual
Prefix:
First Name:MATTHEW
Middle Name:EMERY
Last Name:HARDEE
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 S UNIVERSITY AVE
Mailing Address - Street 2:SUITE 600
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205-5302
Mailing Address - Country:US
Mailing Address - Phone:501-296-3247
Mailing Address - Fax:501-664-8721
Practice Address - Street 1:8901 CARTI WAY
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-6523
Practice Address - Country:US
Practice Address - Phone:501-296-3247
Practice Address - Fax:501-664-8721
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-30
Last Update Date:2021-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE-73722085R0001X, 2085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR5SS48OtherMEDICARE
AR5SS48OtherMEDICARE