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General NPI Number Information
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NPI Number | 1912042136
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Entity Type | Organization
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Legal Business Name | SOUTHEASTERN HEARING INC.
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Dates
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Enumeration Date | 02/21/2007
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Last Update Date | 01/24/2025
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Provider Practice Location Address
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Address Line | 12220 ATLANTIC BLVD UNIT 113
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City | JACKSONVILLE
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State | FL
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Zip | 32225-5822
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Country | US
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Telephone | 904-220-3277
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Fax |
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Provider Business Mailing Address
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Address Line | 4006 3RD ST S
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City | JACKSONVILLE BEACH
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State | FL
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Zip | 32250
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Country | US
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Telephone | 904-247-4327
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Fax | 904-247-4328
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. TROY C MAHAN
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Credential | HIS-BC
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Telephone | 904-247-4327
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 237700000X
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Taxonomy Name | Hearing Instrument Specialist
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License Number |
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License Number State |
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