Provider Demographics
NPI:1457445942
Name:SOUTHWESTERN HEARING CENTER, PA
Entity Type:Organization
Organization Name:SOUTHWESTERN HEARING CENTER, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:R
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:505-982-4848
Mailing Address - Street 1:435 SAINT MICHAELS DR STE B104
Mailing Address - Street 2:
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87505-7671
Mailing Address - Country:US
Mailing Address - Phone:505-946-3955
Mailing Address - Fax:505-982-2996
Practice Address - Street 1:435 SAINT MICHAELS DR STE B104
Practice Address - Street 2:
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87505-7671
Practice Address - Country:US
Practice Address - Phone:505-946-3955
Practice Address - Fax:505-982-2996
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-02
Last Update Date:2020-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty