Provider Demographics
NPI:1457775983
Name:DOCTOR'S HEARING CENTER, INC.
Entity Type:Organization
Organization Name:DOCTOR'S HEARING CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:EVELYN
Authorized Official - Middle Name:M
Authorized Official - Last Name:ANDREWS
Authorized Official - Suffix:
Authorized Official - Credentials:BA, MLS
Authorized Official - Phone:770-676-7208
Mailing Address - Street 1:11180 STATE BRIDGE RD
Mailing Address - Street 2:SUITE 207
Mailing Address - City:JOHNS CREEK
Mailing Address - State:GA
Mailing Address - Zip Code:30022-7482
Mailing Address - Country:US
Mailing Address - Phone:770-676-7208
Mailing Address - Fax:770-676-7283
Practice Address - Street 1:11180 STATE BRIDGE RD
Practice Address - Street 2:SUITE 207
Practice Address - City:JOHNS CREEK
Practice Address - State:GA
Practice Address - Zip Code:30022-7482
Practice Address - Country:US
Practice Address - Phone:770-676-7208
Practice Address - Fax:770-676-7283
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-04
Last Update Date:2014-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAAUD000683231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA1336155886OtherNPI
GA64PCBBVMedicare PIN
GA1336155886OtherNPI