Healthcare Provider Details

I. General information

NPI: 1003009614
Provider Name (Legal Business Name): AUDIOLOGY CONSULTANTS OF LOUISIANA, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/27/2007
Last Update Date: 09/02/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1408 METRO DR
ALEXANDRIA LA
71301-3424
US

IV. Provider business mailing address

PO BOX 13785
ALEXANDRIA LA
71315-3785
US

V. Phone/Fax

Practice location:
  • Phone: 318-445-6998
  • Fax: 318-445-8389
Mailing address:
  • Phone: 318-445-6998
  • Fax: 318-445-8389

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number4412A
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code332S00000X
TaxonomyHearing Aid Equipment
License Number4412A
License Number StateLA

VIII. Authorized Official

Name: DR. ASHLEY LAMMONS
Title or Position: PRESIDENT
Credential: AU.D.
Phone: 318-445-6998