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General NPI Number Information
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NPI Number | 1891701058
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Entity Type | Individual
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Provider Name | KENNETH W. HEARD PH.D.
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Gender | Male
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Dates
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Enumeration Date | 07/31/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1670 CLAIRMONT ROAD
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City | DECATUR
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State | GA
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Zip | 30033
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Country | US
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Telephone | 404-728-7625
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Fax |
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Provider Business Mailing Address
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Address Line | 5198 STRATHAM DR
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City | DUNWOODY
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State | GA
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Zip | 30338-4325
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Country | US
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Telephone | 770-804-8297
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Fax |
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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 | 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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