Healthcare Provider Details

I. General information

NPI: 1316017445
Provider Name (Legal Business Name): DOCTORS HEARING CENTER LLC XIII
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/08/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

413 S SPRINGFIELD AVE
BOLIVAR MO
65613
US

IV. Provider business mailing address

2227 WEST MAIN STREET
JACKSONVILLE AR
72076
US

V. Phone/Fax

Practice location:
  • Phone: 417-326-2654
  • Fax: 417-326-2654
Mailing address:
  • Phone: 501-985-9944
  • Fax: 501-985-6590

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. RONALD F DAVIS
Title or Position: PARTNER SEC TREAS
Credential:
Phone: 501-985-9944