Healthcare Provider Details
I. General information
NPI: 1225330426
Provider Name (Legal Business Name): AZENT HEARING CENTRE LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/22/2010
Last Update Date: 11/22/2010
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
13949 W MEEKER BLVD SUITE C
SUN CITY WEST AZ
85375-4436
US
IV. Provider business mailing address
13949 W MEEKER BLVD SUITE C
SUN CITY WEST AZ
85375-4436
US
V. Phone/Fax
- Phone: 623-975-0879
- Fax: 623-975-1654
- Phone: 623-975-0879
- Fax: 623-975-1654
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 174400000X |
| Taxonomy | Specialist |
| License Number | 24954 |
| License Number State | AZ |
VIII. Authorized Official
Name: DR.
RALPH
E
BASSETT
Title or Position: PHYSICIAN OWNER
Credential: MD
Phone: 623-975-1660