Healthcare Provider Details

I. General information

NPI: 1992976377
Provider Name (Legal Business Name): KENCUR INC STATCO HEARING LABS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/13/2008
Last Update Date: 07/11/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4000 MCCAIN BLVD SUITE D
NORTH LITTLE ROCK AR
72116
US

IV. Provider business mailing address

4000 MCCAIN BLVD SUITE D
NORTH LITTLE ROCK AR
72116
US

V. Phone/Fax

Practice location:
  • Phone: 501-771-2444
  • Fax: 501-771-0330
Mailing address:
  • Phone: 501-771-2444
  • Fax: 501-771-0330

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number497
License Number StateAR

VIII. Authorized Official

Name: GARY KIM CURTIS
Title or Position: OWNER
Credential: HEARING INST SPC
Phone: 501-771-2444