Provider Demographics
NPI:1164696746
Name:CAPE GIRARDEAU AUDIOLOGY
Entity Type:Organization
Organization Name:CAPE GIRARDEAU AUDIOLOGY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OTOLARYNGOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:DON
Authorized Official - Middle Name:CURTIS
Authorized Official - Last Name:COONCE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:573-335-4448
Mailing Address - Street 1:150 S MOUNT AUBURN RD
Mailing Address - Street 2:SUITE 420
Mailing Address - City:CAPE GIRARDEAU
Mailing Address - State:MO
Mailing Address - Zip Code:63703-4911
Mailing Address - Country:US
Mailing Address - Phone:573-335-4448
Mailing Address - Fax:573-335-4466
Practice Address - Street 1:150 S MOUNT AUBURN RD
Practice Address - Street 2:SUITE 420
Practice Address - City:CAPE GIRARDEAU
Practice Address - State:MO
Practice Address - Zip Code:63703-4911
Practice Address - Country:US
Practice Address - Phone:573-335-4448
Practice Address - Fax:573-335-4466
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SEMO OTOLARYNGOLOGY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-04-15
Last Update Date:2008-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty