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General NPI Number Information
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NPI Number | 1174746853
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Entity Type | Organization
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Legal Business Name | COLORADO SPRINGS EAR ASSOCIATES
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Dates
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Enumeration Date | 04/11/2007
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Last Update Date | 05/20/2021
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Provider Practice Location Address
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Address Line | 2950 PROFESSIONAL PL STE 100
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City | COLORADO SPRINGS
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State | CO
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Zip | 80904-8106
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Country | US
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Telephone | 719-667-1327
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Fax | 719-667-1328
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Provider Business Mailing Address
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Address Line | 2950 PROFESSIONAL PL STE 100
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City | COLORADO SPRINGS
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State | CO
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Zip | 80904-8106
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Country | US
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Telephone | 719-667-1327
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Fax | 719-667-1328
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Authorized Official
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Title or Position | MEMBER MANAGER
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Name | DR. JOSEPH L HEGARTY
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Credential | MD
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Telephone | 719-667-1327
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0700X
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Taxonomy Name | Hearing and Speech Clinic/Center
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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 | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 332S00000X
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Taxonomy Name | Hearing Aid Equipment
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 207YX0901X
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Taxonomy Name | Otology & Neurotology Physician
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License Number | 39522
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License Number State | CO
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