MEDICARE: JAMES WAIDE HANKLA AU.D., CCC-A

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	231H00000X	Audiologist	AY392	FL
2	237600000X	Audiologist-Hearing Aid Fitter	AUD000531	GA
3	231H00000X	Audiologist	AUD000531	GA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1437155108
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMES WAIDE HANKLA AU.D., CCC-A

Provider Business Mailing Address
First Line	:	1705 BOULEVARD SQ STE B
Second Line	:
City	:	WAYCROSS
State	:	GA
Zip	:	31501-8032
Country	:	US
Telephone Number	:	912-284-9200
Fax Number	:	912-284-9887

Provider Business Practice Location Address
First Line	:	1705 BOULEVARD SQ STE B
Second Line	:
City	:	WAYCROSS
State	:	GA
Zip	:	31501
Country	:	US
Telephone Number	:	912-284-9200
Fax Number	:	912-284-9887

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

Provider Enumeration Date	:	06/27/2005
Last Update Date	:	08/14/2018

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