MEDICARE: MR. RONALD E BEHEYT HIS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	237700000X	Hearing Instrument Specialist	17001271A	IN

General Provider Information

NPI Number	:	1033359476
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. RONALD E BEHEYT HIS

Provider Business Mailing Address
First Line	:	405 JOHNSON RD STE B
Second Line	:
City	:	TRAIL CREEK
State	:	IN
Zip	:	46360-6682
Country	:	US
Telephone Number	:	574-440-0188
Fax Number	:

Provider Business Practice Location Address
First Line	:	405 JOHNSON RD STE B
Second Line	:
City	:	TRAIL CREEK
State	:	IN
Zip	:	46360-6682
Country	:	US
Telephone Number	:	574-440-0188
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/25/2009
Last Update Date	:	09/07/2016

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