Healthcare Provider Details

I. General information

NPI: 1609034669
Provider Name (Legal Business Name): PANHANDLE HEARING INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/27/2008
Last Update Date: 05/27/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 MARY ESTHER BLVD
MARY ESTHER FL
32569-1693
US

IV. Provider business mailing address

662 HIGHWAY 98 E STE 140
DESTIN FL
32541-2473
US

V. Phone/Fax

Practice location:
  • Phone: 850-243-3196
  • Fax: 850-243-8294
Mailing address:
  • Phone: 850-650-6988
  • Fax: 850-650-6989

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number270010706883
License Number StateFL

VIII. Authorized Official

Name: MR. CHRISTOPHER R HICKS
Title or Position: HEARING INSTRUMENT SPECIALIST/VP
Credential: BC-HIS
Phone: 850-243-3196