Provider Demographics
NPI:1144587114
Name:ALL MISSISSIPPI HEARING, INC.
Entity Type:Organization
Organization Name:ALL MISSISSIPPI HEARING, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF AUDIOLOGY
Authorized Official - Prefix:
Authorized Official - First Name:CARL
Authorized Official - Middle Name:J
Authorized Official - Last Name:HIBBERT
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:601-420-4001
Mailing Address - Street 1:2657 LAKELAND DR STE B
Mailing Address - Street 2:
Mailing Address - City:FLOWOOD
Mailing Address - State:MS
Mailing Address - Zip Code:39232-9516
Mailing Address - Country:US
Mailing Address - Phone:601-420-4001
Mailing Address - Fax:
Practice Address - Street 1:2657 LAKELAND DR STE B
Practice Address - Street 2:
Practice Address - City:FLOWOOD
Practice Address - State:MS
Practice Address - Zip Code:39232-9516
Practice Address - Country:US
Practice Address - Phone:601-420-4001
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-16
Last Update Date:2012-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSA2573231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS640000022Medicare UPIN