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General NPI Number Information
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NPI Number | 1518521723
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Entity Type | Organization
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Legal Business Name | HEARING DOCTORS OF IDAHO, LLC
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Dates
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Enumeration Date | 04/24/2019
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Last Update Date | 05/02/2019
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Provider Practice Location Address
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Address Line | 459 LOCUST ST N STE 110
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City | TWIN FALLS
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State | ID
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Zip | 83301-7324
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Country | US
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Telephone | 208-969-9011
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Fax |
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Provider Business Mailing Address
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Address Line | 618 N SENORA WAY
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City | EAGLE
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State | ID
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Zip | 83616-6893
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Country | US
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Telephone | 208-284-8790
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Fax |
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Authorized Official
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Title or Position | AUDIOLOGIST
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Name | DR. MICHAEL DEAN BATEMAN
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Credential | AUD
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Telephone | 208-284-8790
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 231H00000X
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Taxonomy Name | Audiologist
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License Number |
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License Number State |
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