MEDICARE: SHANE DOLLARHITE AU.D.

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	4404	OK

General Provider Information

NPI Number	:	1578946810
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHANE DOLLARHITE AU.D.

Provider Business Mailing Address
First Line	:	4303 PITMAN ST
Second Line	:
City	:	FORT SILL
State	:	OK
Zip	:	73503-4473
Country	:	US
Telephone Number	:	580-585-5862
Fax Number	:

Provider Business Practice Location Address
First Line	:	4303 PITMAN ST
Second Line	:
City	:	FORT SILL
State	:	OK
Zip	:	73503-4473
Country	:	US
Telephone Number	:	580-585-5862
Fax Number	:

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

Provider Enumeration Date	:	07/06/2015
Last Update Date	:	04/15/2025

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