Provider Demographics
NPI:1386833259
Name:AUDIOLOGY & HEARING SERVICES INC.
Entity Type:Organization
Organization Name:AUDIOLOGY & HEARING SERVICES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF AUDIOLOGY/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:K
Authorized Official - Last Name:THELEN, AU.D.
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:920-731-9611
Mailing Address - Street 1:2245 S ONEIDA ST
Mailing Address - Street 2:
Mailing Address - City:APPLETON
Mailing Address - State:WI
Mailing Address - Zip Code:54915-1657
Mailing Address - Country:US
Mailing Address - Phone:920-731-9611
Mailing Address - Fax:920-731-1950
Practice Address - Street 1:2245 S ONEIDA ST
Practice Address - Street 2:
Practice Address - City:APPLETON
Practice Address - State:WI
Practice Address - Zip Code:54915-1657
Practice Address - Country:US
Practice Address - Phone:920-731-9611
Practice Address - Fax:920-731-1950
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-17
Last Update Date:2007-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI165237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid FitterGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1018213OtherAMERICHOICE
WI1906795OtherUNITEDHEALTHCARE
WI41104000Medicaid
WIS55059Medicare UPIN
WI86364Medicare PIN