Provider Demographics
NPI:1043619356
Name:MCCURLEY HEARING DESIGN LLC
Entity Type:Organization
Organization Name:MCCURLEY HEARING DESIGN LLC
Other - Org Name:MCCURLEY HEARING DESIGN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/AUDIOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DOROTHY
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCURLEY
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:626-298-0409
Mailing Address - Street 1:14206 ARCADIA RD NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87123-2433
Mailing Address - Country:US
Mailing Address - Phone:626-298-0409
Mailing Address - Fax:505-508-2513
Practice Address - Street 1:401 EDITH BLVD NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87102-2509
Practice Address - Country:US
Practice Address - Phone:505-243-8030
Practice Address - Fax:505-208-2513
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-22
Last Update Date:2015-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM443231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM300675Medicare UPIN