Provider Demographics
NPI:1669782207
Name:AREA HEARING & SPEECH CLINIC, INC.
Entity type:Organization
Organization Name:AREA HEARING & SPEECH CLINIC, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUDIOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:HANY
Authorized Official - Middle Name:M
Authorized Official - Last Name:MIKHAIL
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:417-781-2311
Mailing Address - Street 1:2311 JACKSON AVE.
Mailing Address - Street 2:
Mailing Address - City:JOPLIN
Mailing Address - State:MO
Mailing Address - Zip Code:64804
Mailing Address - Country:US
Mailing Address - Phone:417-781-2311
Mailing Address - Fax:417-781-6477
Practice Address - Street 1:2311 JACKSON AVE.
Practice Address - Street 2:
Practice Address - City:JOPLIN
Practice Address - State:MO
Practice Address - Zip Code:64804
Practice Address - Country:US
Practice Address - Phone:417-781-2311
Practice Address - Fax:417-781-6477
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-18
Last Update Date:2010-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO02033261QH0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100712960EMedicaid
MO332828508Medicaid
KS100228920BMedicaid
OK100712960EMedicaid