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General NPI Number Information
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NPI Number | 1174055263
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Entity Type | Individual
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Provider Name | CAROL ROOBIN BASHUK M.ED
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Gender | Female
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Dates
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Enumeration Date | 03/29/2017
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Last Update Date | 09/14/2022
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Provider Practice Location Address
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Address Line | 634 FIRST STREET
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City | MACON
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State | GA
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Zip | 31201
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Country | US
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Telephone | 478-743-1452
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Fax | 478-743-3338
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Provider Business Mailing Address
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Address Line | 2440 INGLESIDE AVE STE C
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City | MACON
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State | GA
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Zip | 31204-2096
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Country | US
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Telephone | 478-743-1452
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Fax | 478-743-3338
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 237700000X
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Taxonomy Name | Hearing Instrument Specialist
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License Number | HADS000136
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License Number State | GA
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