Provider Demographics
NPI:1053919498
Name:SOUTHERN HEARING LLC
Entity type:Organization
Organization Name:SOUTHERN HEARING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/HEARING AID SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:HANCOCK
Authorized Official - Suffix:
Authorized Official - Credentials:HAS
Authorized Official - Phone:601-264-2692
Mailing Address - Street 1:105 N 40TH AVE
Mailing Address - Street 2:
Mailing Address - City:HATTIESBURG
Mailing Address - State:MS
Mailing Address - Zip Code:39401-6606
Mailing Address - Country:US
Mailing Address - Phone:601-264-2692
Mailing Address - Fax:601-336-8127
Practice Address - Street 1:105 N 40TH AVE
Practice Address - Street 2:
Practice Address - City:HATTIESBURG
Practice Address - State:MS
Practice Address - Zip Code:39401-6606
Practice Address - Country:US
Practice Address - Phone:601-264-2692
Practice Address - Fax:601-336-8127
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-16
Last Update Date:2020-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument SpecialistGroup - Single Specialty