Provider Demographics
NPI:1518566314
Name:CAPITAL HEARING CENTER LLC
Entity Type:Organization
Organization Name:CAPITAL HEARING CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:DOTY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:601-939-9595
Mailing Address - Street 1:628 LAKELAND EAST DR STE A
Mailing Address - Street 2:
Mailing Address - City:FLOWOOD
Mailing Address - State:MS
Mailing Address - Zip Code:39232-9565
Mailing Address - Country:US
Mailing Address - Phone:601-939-9595
Mailing Address - Fax:601-939-9504
Practice Address - Street 1:628 LAKELAND EAST DR STE A
Practice Address - Street 2:
Practice Address - City:FLOWOOD
Practice Address - State:MS
Practice Address - Zip Code:39232-9565
Practice Address - Country:US
Practice Address - Phone:601-939-9595
Practice Address - Fax:601-939-9504
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-22
Last Update Date:2020-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech