Provider Demographics
NPI:1003924366
Name:HEARING SPECIALISTS OF NORTHERN MICHIGAN
Entity Type:Organization
Organization Name:HEARING SPECIALISTS OF NORTHERN MICHIGAN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUDIOLOGIST / OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:K
Authorized Official - Last Name:BIRCHFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:MA, CCC-A
Authorized Official - Phone:231-347-1800
Mailing Address - Street 1:2325 SUMMIT PARK DR STE B
Mailing Address - Street 2:
Mailing Address - City:PETOSKEY
Mailing Address - State:MI
Mailing Address - Zip Code:49770-8685
Mailing Address - Country:US
Mailing Address - Phone:231-347-1800
Mailing Address - Fax:231-347-1864
Practice Address - Street 1:2325 SUMMIT PARK DR STE B
Practice Address - Street 2:
Practice Address - City:PETOSKEY
Practice Address - State:MI
Practice Address - Zip Code:49770-8685
Practice Address - Country:US
Practice Address - Phone:231-347-1800
Practice Address - Fax:231-347-1864
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI1601000052237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid FitterGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0P14360Medicare ID - Type Unspecified