Provider Demographics
NPI:1467837468
Name:ATLANTA HEARING ASSOCIATES OF LAKE OCONEE, LLC
Entity Type:Organization
Organization Name:ATLANTA HEARING ASSOCIATES OF LAKE OCONEE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:JOY
Authorized Official - Middle Name:W
Authorized Official - Last Name:PRITCHETT
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:478-452-0578
Mailing Address - Street 1:111 FIELDSTONE DR
Mailing Address - Street 2:SUITE 106
Mailing Address - City:MILLEDGEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:31061-7106
Mailing Address - Country:US
Mailing Address - Phone:478-452-0578
Mailing Address - Fax:478-453-0967
Practice Address - Street 1:1051 PARKSIDE CMNS
Practice Address - Street 2:SUITE 103
Practice Address - City:GREENSBORO
Practice Address - State:GA
Practice Address - Zip Code:30642-4516
Practice Address - Country:US
Practice Address - Phone:706-454-0578
Practice Address - Fax:706-454-0575
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HEARING ASSOCIATES OF MIDDLE GEORGIA, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-07-21
Last Update Date:2015-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAAUD000571231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty