Healthcare Provider Details

I. General information

NPI: 1780198929
Provider Name (Legal Business Name): ATKINS HEARING CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/27/2017
Last Update Date: 11/27/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2308 E DOLORES RD
PHOENIX AZ
85086-9329
US

IV. Provider business mailing address

2308 E DOLORES RD
PHOENIX AZ
85086-9329
US

V. Phone/Fax

Practice location:
  • Phone: 937-605-5405
  • Fax:
Mailing address:
  • Phone: 937-605-5405
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QH0700X
TaxonomyHearing and Speech Clinic/Center
License Number
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License NumberHAD7113
License Number StateAZ

VIII. Authorized Official

Name: DOUGLAS MATTHEW ATKINS
Title or Position: OWNER
Credential: BC-HIS
Phone: 937-605-5405