Healthcare Provider Details

I. General information

NPI: 1164477899
Provider Name (Legal Business Name): SUSAN JANE PARR AU.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/23/2006
Last Update Date: 08/31/2022
Certification Date: 08/30/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

HABERSHAM MEDICAL CENTER 541 HISTORIC HWY #441-N
DEMOREST GA
30535-6025
US

IV. Provider business mailing address

HABERSHAM MEDICAL CENTER 541 HISTORIC HWY #441-N
DEMOREST GA
30535-6025
US

V. Phone/Fax

Practice location:
  • Phone: 706-839-4050
  • Fax: 888-965-9908
Mailing address:
  • Phone: 706-839-4050
  • Fax: 888-965-9908

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License NumberAT000566L
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code231HA2400X
TaxonomyAssistive Technology Practitioner Audiologist
License NumberAT000566L
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License NumberF03251
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: