Provider Demographics
NPI:1467898452
Name:HOULDITCH, BOBBY DEAN II
Entity Type:Individual
Prefix:MR
First Name:BOBBY
Middle Name:DEAN
Last Name:HOULDITCH
Suffix:II
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2007 PARKWOOD DR
Mailing Address - Street 2:COASTAL HEARING AND BALANCE
Mailing Address - City:BRUNSWICK
Mailing Address - State:GA
Mailing Address - Zip Code:31520-4701
Mailing Address - Country:US
Mailing Address - Phone:912-267-1400
Mailing Address - Fax:
Practice Address - Street 1:2007 PARKWOOD DR
Practice Address - Street 2:COASTAL HEARING AND BALANCE
Practice Address - City:BRUNSWICK
Practice Address - State:GA
Practice Address - Zip Code:31520-4701
Practice Address - Country:US
Practice Address - Phone:912-267-1400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-16
Last Update Date:2013-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAHADS000881237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist