Healthcare Provider Details

I. General information

NPI: 1679157580
Provider Name (Legal Business Name): JOSHUA WHICKER AUD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/06/2021
Last Update Date: 11/17/2021
Certification Date: 11/17/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1655 SHILOH RD STE D
BILLINGS MT
59106-1726
US

IV. Provider business mailing address

2206 MAIN ST
MILES CITY MT
59301-3802
US

V. Phone/Fax

Practice location:
  • Phone: 406-969-2770
  • Fax: 406-233-3985
Mailing address:
  • Phone: 406-853-2188
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332S00000X
TaxonomyHearing Aid Equipment
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: