Provider Demographics
NPI:1033234687
Name:AUBURN UNIVERSITY MONTGOMERY
Entity Type:Organization
Organization Name:AUBURN UNIVERSITY MONTGOMERY
Other - Org Name:AUM SPEECH AND HEARING CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PROFESSOR DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:E
Authorized Official - Last Name:BORTON
Authorized Official - Suffix:
Authorized Official - Credentials:PHD FAAA CCC-A
Authorized Official - Phone:334-244-3408
Mailing Address - Street 1:PO BOX 244023
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36124-4023
Mailing Address - Country:US
Mailing Address - Phone:334-244-3408
Mailing Address - Fax:334-244-3906
Practice Address - Street 1:7041 SENATORS DR
Practice Address - Street 2:LIBERAL ARTS BUILDING ROOM 110
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36117
Practice Address - Country:US
Practice Address - Phone:334-244-3408
Practice Address - Fax:334-244-3906
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AUBURN UNIVERSITY MONTGOMERY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-03-20
Last Update Date:2008-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL529102020Medicaid