Provider Demographics
NPI:1497297311
Name:ALL MISSISSIPPI HEARING, INC
Entity Type:Organization
Organization Name:ALL MISSISSIPPI HEARING, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT - CO-OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CARL
Authorized Official - Middle Name:J
Authorized Official - Last Name:HIBBERT
Authorized Official - Suffix:
Authorized Official - Credentials:AUDIOLOGIST
Authorized Official - Phone:601-420-4001
Mailing Address - Street 1:2657 LAKELAND DR STE B
Mailing Address - Street 2:
Mailing Address - City:FLOWOOD
Mailing Address - State:MS
Mailing Address - Zip Code:39232-9516
Mailing Address - Country:US
Mailing Address - Phone:601-420-4001
Mailing Address - Fax:601-420-4005
Practice Address - Street 1:2657 LAKELAND DR STE B
Practice Address - Street 2:
Practice Address - City:FLOWOOD
Practice Address - State:MS
Practice Address - Zip Code:39232-9516
Practice Address - Country:US
Practice Address - Phone:601-420-4001
Practice Address - Fax:601-420-4005
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-09
Last Update Date:2016-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSA2573261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
MSP33577Medicare UPIN