MEDICARE: KENTUCKY DOCTORS OF AUDIOLOGY

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	101932	KY
2	231H00000X	Audiologist	100078	KY

General Provider Information

NPI Number	:	1437682408
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KENTUCKY DOCTORS OF AUDIOLOGY

Provider Business Mailing Address
First Line	:	1707 CUMBERLAND FALLS HWY
Second Line	:	SUITE U7
City	:	CORBIN
State	:	KY
Zip	:	40701-2743
Country	:	US
Telephone Number	:	606-528-9993
Fax Number	:

Provider Business Practice Location Address
First Line	:	1707 CUMBERLAND FALLS HWY
Second Line	:	SUITE U7
City	:	CORBIN
State	:	KY
Zip	:	40701-2743
Country	:	US
Telephone Number	:	606-528-9993
Fax Number	:

Authorized Official
Title or Position	:	OWNER/AUDIOLOGIST
Name	:	DR. ELIZABETH ROGERS
Credential	:	AU.D.
Telephone Number	:	606-528-9993

Provider Enumeration Date	:	04/06/2017
Last Update Date	:	06/28/2017

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