Healthcare Provider Details

I. General information

NPI: 1174980759
Provider Name (Legal Business Name): PHYSICIANS CHOICE HEARING CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/27/2016
Last Update Date: 05/08/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1020 PROFESSIONAL BLVD
EVANSVILLE IN
47714-8009
US

IV. Provider business mailing address

1020 PROFESSIONAL BLVD
EVANSVILLE IN
47714-8009
US

V. Phone/Fax

Practice location:
  • Phone: 812-473-2060
  • Fax: 812-473-0763
Mailing address:
  • Phone: 812-473-2060
  • Fax: 812-473-0763

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number164541
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number164541
License Number StateIN
# 3
Primary TaxonomyN
Taxonomy Code332S00000X
TaxonomyHearing Aid Equipment
License Number01029120A
License Number StateIN

VIII. Authorized Official

Name: CHELSEA SKAGGS
Title or Position: HEARING INSTRUMENT SPECIALIST
Credential:
Phone: 812-319-1683