Healthcare Provider Details

I. General information

NPI: 1043521875
Provider Name (Legal Business Name): HEARING AID GROUP OF ARKANSAS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/25/2010
Last Update Date: 06/25/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 N MISSOURI ST
WEST MEMPHIS AR
72301-3148
US

IV. Provider business mailing address

600 N MISSOURI ST
WEST MEMPHIS AR
72301-3148
US

V. Phone/Fax

Practice location:
  • Phone: 870-735-0454
  • Fax:
Mailing address:
  • Phone: 870-735-0454
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number353
License Number StateAR

VIII. Authorized Official

Name: MR. GARY PEARSON
Title or Position: OWNER
Credential:
Phone: 870-735-0454