Healthcare Provider Details

I. General information

NPI: 1467646877
Provider Name (Legal Business Name): HAWKINS HEARING CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/29/2007
Last Update Date: 10/09/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

33120 STATION ST
SOLON OH
44139-2910
US

IV. Provider business mailing address

33120 STATION ST
SOLON OH
44139-2910
US

V. Phone/Fax

Practice location:
  • Phone: 440-248-4790
  • Fax:
Mailing address:
  • Phone: 440-248-4790
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0700X
TaxonomyHearing and Speech Clinic/Center
License NumberA01256
License Number StateOH

VIII. Authorized Official

Name: CAROL J HAWKINS
Title or Position: PRESIDENT
Credential: AU.D.
Phone: 440-248-4790