MEDICARE: LINDA DORSEY HEARING

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	174400000X	Specialist	491	TN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	20-3458680	OTHER	TN	BLUECROSS BLUESHIELD

General Provider Information

NPI Number	:	1477795227
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LINDA DORSEY HEARING

Provider Business Mailing Address
First Line	:	2538 KEITH ST NW STE 8
Second Line	:
City	:	CLEVELAND
State	:	TN
Zip	:	37312-3738
Country	:	US
Telephone Number	:	423-478-3085
Fax Number	:	423-339-9524

Provider Business Practice Location Address
First Line	:	2538 KEITH ST NW STE 8
Second Line	:
City	:	CLEVELAND
State	:	TN
Zip	:	37312-3738
Country	:	US
Telephone Number	:	423-478-3085
Fax Number	:	423-339-9524

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

Provider Enumeration Date	:	03/25/2009
Last Update Date	:	03/25/2009

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Directions to “ LINDA DORSEY HEARING” Practice Location

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