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NPI Code Detail

MEDICARE: AMBER MARIE BUCKHALTER HIS

MEDICARE: AMBER MARIE BUCKHALTER HIS
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
1237700000XHearing Instrument SpecialistHA-695MS

General Provider Information

NPI Number : 1982279907
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMBER MARIE BUCKHALTER HIS
Provider Business Mailing Address
First Line : 2102 MACARTHUR DR STE C
Second Line :
City : ALEXANDRIA
State : LA
Zip : 71301-3763
Country : US
Telephone Number : 318-484-3755
Fax Number : 318-484-3499
Provider Business Practice Location Address
First Line : 2102 MACARTHUR DR STE C
Second Line :
City : ALEXANDRIA
State : LA
Zip : 71301-3763
Country : US
Telephone Number : 318-484-3755
Fax Number : 318-484-3499
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/21/2021
Last Update Date : 05/21/2021

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