Provider Demographics
NPI:1275530115
Name:VOSS, JOHN H (AUD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:H
Last Name:VOSS
Suffix:
Gender:M
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4905 MATTERHORN DR
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55811-3851
Mailing Address - Country:US
Mailing Address - Phone:218-723-7880
Mailing Address - Fax:218-723-8208
Practice Address - Street 1:4905 MATTERHORN DR
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:MN
Practice Address - Zip Code:55811-3851
Practice Address - Country:US
Practice Address - Phone:218-723-7880
Practice Address - Fax:218-723-8208
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-07
Last Update Date:2010-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN5119231H00000X
WI94156231H00000X
MN2017237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN14319VOOtherBLUECROSS/BLUESHIELD
MN917565200Medicaid
MN4505036OtherMEDICA #
WI41112500Medicaid
MN659497200Medicaid
MN14319VOOtherBLUECROSS/BLUESHIELD
MN640000114Medicare ID - Type UnspecifiedAUDIOLOGIST-MEDICARE