Provider Demographics
NPI:1558510628
Name:AUDIOLOGISTS & HEARING AID SPECIALISTS OF KENTUCKY PLLC
Entity Type:Organization
Organization Name:AUDIOLOGISTS & HEARING AID SPECIALISTS OF KENTUCKY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:VICTORIA
Authorized Official - Middle Name:CALLIHAN
Authorized Official - Last Name:GRAFF
Authorized Official - Suffix:
Authorized Official - Credentials:AU D
Authorized Official - Phone:859-276-4327
Mailing Address - Street 1:1401 HARRODSBURG RD
Mailing Address - Street 2:B85
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40504-3751
Mailing Address - Country:US
Mailing Address - Phone:829-276-4327
Mailing Address - Fax:859-278-0923
Practice Address - Street 1:1401 HARRODSBURG RD
Practice Address - Street 2:B85
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40504-3751
Practice Address - Country:US
Practice Address - Phone:829-276-4327
Practice Address - Fax:859-278-0923
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-15
Last Update Date:2008-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY201231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY3017001Medicare PIN