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General NPI Number Information
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NPI Number | 1013425339
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Entity Type | Individual
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Provider Name | JONATHAN WAYNE JAMES HEARING AID DEALER
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Gender | Male
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Dates
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Enumeration Date | 01/22/2018
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Last Update Date | 01/22/2018
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Provider Practice Location Address
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Address Line | 601 N 15 1/2 STREET
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City | VINCENNES
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State | IN
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Zip | 47591-4759
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Country | US
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Telephone | 812-882-4715
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Fax | 812-882-4922
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Provider Business Mailing Address
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Address Line | 601 N 15TH 1/2 ST
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City | VINCENNES
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State | IN
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Zip | 47591-5607
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Country | US
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Telephone | 812-882-4715
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Fax | 812-882-4922
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 237600000X
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Taxonomy Name | Audiologist-Hearing Aid Fitter
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License Number | 770019588
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License Number State | IN
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