Healthcare Provider Details

I. General information

NPI: 1518330786
Provider Name (Legal Business Name): AUDIOLOGY AND HEARING AID SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/10/2015
Last Update Date: 09/18/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5201 FREDERICK ST
SAVANNAH GA
31405-4501
US

IV. Provider business mailing address

5203 FREDERICK ST
SAVANNAH GA
31405-4501
US

V. Phone/Fax

Practice location:
  • Phone: 912-351-3030
  • Fax: 912-951-3039
Mailing address:
  • Phone: 912-351-3030
  • Fax: 912-951-3039

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number
License Number State

VIII. Authorized Official

Name: DR. MICHAEL ZOLLER
Title or Position: MD
Credential: MD
Phone: 912-351-3030