Provider Demographics
NPI:1093066839
Name:WILLIAMS HEARING, INC.
Entity Type:Organization
Organization Name:WILLIAMS HEARING, INC.
Other - Org Name:MIRACLE EAR
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:T
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:208-552-1166
Mailing Address - Street 1:3200 CHANNING WAY STE A101
Mailing Address - Street 2:
Mailing Address - City:IDAHO FALLS
Mailing Address - State:ID
Mailing Address - Zip Code:83404-7561
Mailing Address - Country:US
Mailing Address - Phone:208-552-1166
Mailing Address - Fax:208-552-0470
Practice Address - Street 1:3200 CHANNING WAY STE A101
Practice Address - Street 2:
Practice Address - City:IDAHO FALLS
Practice Address - State:ID
Practice Address - Zip Code:83404-7561
Practice Address - Country:US
Practice Address - Phone:208-552-1166
Practice Address - Fax:208-552-0470
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-19
Last Update Date:2012-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDHA-1852237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument SpecialistGroup - Single Specialty