MEDICARE: RONALD D. MIDDLETON

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	HAD4757	AZ

General Provider Information

NPI Number	:	1053572305
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RONALD D. MIDDLETON

Provider Business Mailing Address
First Line	:	6479 E 22ND ST
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85710-5115
Country	:	US
Telephone Number	:	520-323-0099
Fax Number	:	520-290-6905

Provider Business Practice Location Address
First Line	:	6479 E 22ND ST
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85710-5115
Country	:	US
Telephone Number	:	520-323-0099
Fax Number	:	520-290-6905

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

Provider Enumeration Date	:	06/19/2008
Last Update Date	:	06/19/2008

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