Provider Demographics
NPI:1053335794
Name:HARDACKER, JAMES W (MD)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:W
Last Name:HARDACKER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:13431 OLD MERIDIAN ST
Mailing Address - Street 2:STE 200
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46032-1498
Mailing Address - Country:US
Mailing Address - Phone:317-573-7733
Mailing Address - Fax:317-573-7739
Practice Address - Street 1:13431 OLD MERIDIAN ST STE 200
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46032-1498
Practice Address - Country:US
Practice Address - Phone:317-573-7733
Practice Address - Fax:317-573-7739
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-26
Last Update Date:2023-07-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ININ01041884A207XS0117X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the Spine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100463480AMedicaid
IN200014594Medicare PIN
IN100463480AMedicaid
IN313400AMedicare PIN