MEDICARE: DR. SUSAN L. DETELS AU.D.

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
1	237600000X	Audiologist-Hearing Aid Fitter	21293	OR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1275500829
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SUSAN L. DETELS AU.D.

Provider Business Mailing Address
First Line	:	427 W AZALEA AVE
Second Line	:
City	:	EUGENE
State	:	OR
Zip	:	97404-1894
Country	:	US
Telephone Number	:	541-968-2206
Fax Number	:

Provider Business Practice Location Address
First Line	:	816 BELTLINE RD
Second Line	:
City	:	SPRINGFIELD
State	:	OR
Zip	:	97477-1091
Country	:	US
Telephone Number	:	541-746-7671
Fax Number	:	541-746-2625

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/02/2006
Last Update Date	:	01/07/2026

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