Provider Demographics
NPI:1497900518
Name:HEARING ASSOCIATES OF DOTHAN, LLC
Entity Type:Organization
Organization Name:HEARING ASSOCIATES OF DOTHAN, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUDIOLOGIST/MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMIE
Authorized Official - Middle Name:BURTON
Authorized Official - Last Name:SHUMAKER
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:334-702-4327
Mailing Address - Street 1:200 GROVE PARK LN STE 800
Mailing Address - Street 2:
Mailing Address - City:DOTHAN
Mailing Address - State:AL
Mailing Address - Zip Code:36305-5912
Mailing Address - Country:US
Mailing Address - Phone:334-702-4327
Mailing Address - Fax:334-702-4328
Practice Address - Street 1:200 GROVE PARK LN STE 800
Practice Address - Street 2:
Practice Address - City:DOTHAN
Practice Address - State:AL
Practice Address - Zip Code:36305-5912
Practice Address - Country:US
Practice Address - Phone:334-702-4327
Practice Address - Fax:334-702-4328
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-18
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
231H00000X
AL961A237600000X
AL923A237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid FitterGroup - Single Specialty
No231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL515OtherBCBS OF ALABAMA