Provider Demographics
NPI:1417210725
Name:CARROLL HEARING ASSOCIATES, LLC
Entity Type:Organization
Organization Name:CARROLL HEARING ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUDIOLOGIST-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:R
Authorized Official - Last Name:CARROLL
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CCC-A
Authorized Official - Phone:256-489-9992
Mailing Address - Street 1:333 WHITESPORT DR SW
Mailing Address - Street 2:SUITE 302
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35801-6454
Mailing Address - Country:US
Mailing Address - Phone:256-489-9992
Mailing Address - Fax:
Practice Address - Street 1:333 WHITESPORT DR SW
Practice Address - Street 2:SUITE 302
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-6454
Practice Address - Country:US
Practice Address - Phone:256-489-9992
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-21
Last Update Date:2012-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL579A231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty