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NPI Code Detail

MEDICARE: CHASE PACE AUD

MEDICARE: CHASE PACE AUD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1237600000XAudiologist-Hearing Aid Fitter
2231H00000XAudiologist1238AAL

General Provider Information

NPI Number : 1245888940
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHASE PACE AUD
Provider Business Mailing Address
First Line : 5128 OLD HIGHWAY 11 STE 8
Second Line :
City : HATTIESBURG
State : MS
Zip : 39402-6234
Country : US
Telephone Number : 601-450-0280
Fax Number :
Provider Business Practice Location Address
First Line : 5128 OLD HIGHWAY 11 STE 8
Second Line :
City : HATTIESBURG
State : MS
Zip : 39402-6234
Country : US
Telephone Number : 601-450-0280
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/27/2019
Last Update Date : 10/21/2020

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Directions to “ CHASE PACE AUD” Practice Location

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