Provider Demographics
NPI:1629015649
Name:DEAN, CLINT HESTER (AUDIOLOGIST)
Entity Type:Individual
Prefix:MR
First Name:CLINT
Middle Name:HESTER
Last Name:DEAN
Suffix:
Gender:M
Credentials:AUDIOLOGIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:515 MAIN ST
Mailing Address - Street 2:P.O. BOX 522
Mailing Address - City:COLUMBUS
Mailing Address - State:MS
Mailing Address - Zip Code:39701-5733
Mailing Address - Country:US
Mailing Address - Phone:662-328-8002
Mailing Address - Fax:662-328-8002
Practice Address - Street 1:515 MAIN ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:MS
Practice Address - Zip Code:39701-5733
Practice Address - Country:US
Practice Address - Phone:662-328-8002
Practice Address - Fax:662-328-8002
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-31
Last Update Date:2007-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSHA0043237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist