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General NPI Number Information
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NPI Number | 1508898107
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Entity Type | Organization
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Legal Business Name | WILMINGTON AUDIOLOGY SERVIVCES
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Dates
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Enumeration Date | 07/06/2006
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Last Update Date | 04/02/2009
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Provider Practice Location Address
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Address Line | 2300 PENNSYLVANIA AVE SUITE 1-C
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City | WILMINGTON
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State | DE
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Zip | 19806-1392
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Country | US
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Telephone | 302-654-1011
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Fax |
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Provider Business Mailing Address
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Address Line | 2300 PENNSYLVANIA AVE SUITE 1-C
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City | WILMINGTON
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State | DE
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Zip | 19806-1392
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Country | US
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Telephone | 302-654-1011
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. WILLIAM L. MEDFORD, JR.
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Credential | M.D.
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Telephone | 302-654-1011
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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 | 1989026866
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License Number State | DE
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