Healthcare Provider Details
I. General information
NPI: 1497900518
Provider Name (Legal Business Name): HEARING ASSOCIATES OF DOTHAN, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/18/2008
Last Update Date: 06/16/2018
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
200 GROVE PARK LN STE 800
DOTHAN AL
36305-5912
US
IV. Provider business mailing address
200 GROVE PARK LN STE 800
DOTHAN AL
36305-5912
US
V. Phone/Fax
- Phone: 334-702-4327
- Fax: 334-702-4328
- Phone: 334-702-4327
- Fax: 334-702-4328
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 231H00000X |
| Taxonomy | Audiologist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 237600000X |
| Taxonomy | Audiologist-Hearing Aid Fitter |
| License Number | 961A |
| License Number State | AL |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 237600000X |
| Taxonomy | Audiologist-Hearing Aid Fitter |
| License Number | 923A |
| License Number State | AL |
VIII. Authorized Official
Name: DR.
JAMIE
BURTON
SHUMAKER
Title or Position: AUDIOLOGIST/MEMBER
Credential: AU.D.
Phone: 334-702-4327