Provider Demographics
NPI:1033390992
Name:HEARING SPECIALIST PC
Entity Type:Organization
Organization Name:HEARING SPECIALIST PC
Other - Org Name:HEARING SPECIALISTS P.C.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:COLETTE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:HODDEN
Authorized Official - Suffix:
Authorized Official - Credentials:MA CCC-A
Authorized Official - Phone:712-276-0050
Mailing Address - Street 1:3535 SOUTHERN HILLS DRIVE SUITE D
Mailing Address - Street 2:
Mailing Address - City:SIOUX CITY
Mailing Address - State:IA
Mailing Address - Zip Code:51106-4738
Mailing Address - Country:US
Mailing Address - Phone:712-276-0050
Mailing Address - Fax:712-274-4393
Practice Address - Street 1:3535 SOUTHERN HILLS DRIVE SUITE D
Practice Address - Street 2:
Practice Address - City:SIOUX CITY
Practice Address - State:IA
Practice Address - Zip Code:51106-4738
Practice Address - Country:US
Practice Address - Phone:712-276-0050
Practice Address - Fax:712-274-4393
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-20
Last Update Date:2022-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Multi-Specialty
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid FitterGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA=========Medicaid