Provider Demographics
NPI:1154493450
Name:MIKHAIL, HANY M (AUD)
Entity Type:Individual
Prefix:MR
First Name:HANY
Middle Name:M
Last Name:MIKHAIL
Suffix:
Gender:M
Credentials:AUD
Other - Prefix:
Other - First Name:AREA HEARING
Other - Middle Name:AND
Other - Last Name:SPEECH CLINIC
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:2311 S JACKSON AVE
Mailing Address - Street 2:
Mailing Address - City:JOPLIN
Mailing Address - State:MO
Mailing Address - Zip Code:64804-1936
Mailing Address - Country:US
Mailing Address - Phone:417-781-2311
Mailing Address - Fax:417-781-6477
Practice Address - Street 1:2311 S JACKSON AVE
Practice Address - Street 2:
Practice Address - City:JOPLIN
Practice Address - State:MO
Practice Address - Zip Code:64804-1936
Practice Address - Country:US
Practice Address - Phone:417-781-2311
Practice Address - Fax:417-781-6477
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-14
Last Update Date:2021-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO02033231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100712960EOtherMCD
MO332828508Medicaid
KS100228920BOtherMCD
OK100712960EOtherMCD