Provider Demographics
NPI:1346442217
Name:OCONEE HEARING CENTER, LLC
Entity Type:Organization
Organization Name:OCONEE HEARING CENTER, LLC
Other - Org Name:THE HEARING CENTER AT LAKE OCONEE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO AND PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:EVERETT
Authorized Official - Last Name:SUTTON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:706-453-1688
Mailing Address - Street 1:1041 FOUNDERS ROW
Mailing Address - Street 2:SUITE B
Mailing Address - City:GREENSBORO
Mailing Address - State:GA
Mailing Address - Zip Code:30642-5260
Mailing Address - Country:US
Mailing Address - Phone:706-453-1688
Mailing Address - Fax:706-453-2884
Practice Address - Street 1:1041 FOUNDERS ROW
Practice Address - Street 2:SUITE B
Practice Address - City:GREENSBORO
Practice Address - State:GA
Practice Address - Zip Code:30642-5260
Practice Address - Country:US
Practice Address - Phone:706-453-1688
Practice Address - Fax:706-453-2884
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAAUD003461231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAGRP6856Medicare ID - Type UnspecifiedGROUP NUMBER