MEDICARE: TERESA SOMODY

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	100462	KY

General Provider Information

NPI Number	:	1265068464
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TERESA SOMODY

Provider Business Mailing Address
First Line	:	PO BOX 493
Second Line	:
City	:	LEWISPORT
State	:	KY
Zip	:	42351-0493
Country	:	US
Telephone Number	:	270-925-5729
Fax Number	:

Provider Business Practice Location Address
First Line	:	1915 W PARRISH AVE STE 400
Second Line	:
City	:	OWENSBORO
State	:	KY
Zip	:	42301-3519
Country	:	US
Telephone Number	:	270-683-2609
Fax Number	:

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

Provider Enumeration Date	:	03/19/2020
Last Update Date	:	03/19/2020

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Directions to “ TERESA SOMODY ” Practice Location

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