MEDICARE: KARA A HEADINGTON 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
1	231H00000X	Audiologist	AUD5626	AZ

General Provider Information

NPI Number	:	1720275498
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KARA A HEADINGTON AUD

Provider Business Mailing Address
First Line	:	6124 E BROWN RD
Second Line	:	STE. 102
City	:	MESA
State	:	AZ
Zip	:	85205-4959
Country	:	US
Telephone Number	:	480-497-3285
Fax Number	:	480-833-2513

Provider Business Practice Location Address
First Line	:	6124 E BROWN RD
Second Line	:	STE. 102
City	:	MESA
State	:	AZ
Zip	:	85205-4959
Country	:	US
Telephone Number	:	480-497-3285
Fax Number	:	480-833-2513

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

Provider Enumeration Date	:	09/26/2007
Last Update Date	:	09/26/2007

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Directions to “ KARA A HEADINGTON AUD” Practice Location

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