Provider Demographics
NPI:1043735020
Name:SMOKY MOUNTAIN HEARING SPECIALISTS 2 LLC
Entity Type:Organization
Organization Name:SMOKY MOUNTAIN HEARING SPECIALISTS 2 LLC
Other - Org Name:EAST TENNESSEE AUDIOLOGY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:BRETT
Authorized Official - Middle Name:
Authorized Official - Last Name:PARISH
Authorized Official - Suffix:
Authorized Official - Credentials:HIS
Authorized Official - Phone:423-307-8846
Mailing Address - Street 1:1501 E MORRIS BLVD STE 11
Mailing Address - Street 2:
Mailing Address - City:MORRISTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:37813-5777
Mailing Address - Country:US
Mailing Address - Phone:423-307-8846
Mailing Address - Fax:423-289-1548
Practice Address - Street 1:730 HIGHWAY 321 N STE 101
Practice Address - Street 2:
Practice Address - City:LENOIR CITY
Practice Address - State:TN
Practice Address - Zip Code:37771-5000
Practice Address - Country:US
Practice Address - Phone:423-307-8846
Practice Address - Fax:423-289-1258
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SMOKY MOUNT HEARING SPECIALISTS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-08-10
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN083231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN083OtherAUDIOLOGY