Healthcare Provider Details

I. General information

NPI: 1952564445
Provider Name (Legal Business Name): SATYENDRA KUMAR AU.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/07/2008
Last Update Date: 07/07/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1716 PARR AVE SUITE B
DYERSBURG TN
38024-2073
US

IV. Provider business mailing address

701 WARMSTONE CT
NASHVILLE TN
37209-5032
US

V. Phone/Fax

Practice location:
  • Phone: 731-286-0149
  • Fax: 731-286-6956
Mailing address:
  • Phone: 615-356-4466
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number1190
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number2133
License Number StateTN
# 3
Primary TaxonomyN
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number1190
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: