Provider Demographics
NPI:1679691216
Name:RUSSELL B HEARN & ASSOCIATES
Entity type:Organization
Organization Name:RUSSELL B HEARN & ASSOCIATES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:RUSSELL
Authorized Official - Middle Name:B
Authorized Official - Last Name:HEARN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:724-282-8491
Mailing Address - Street 1:1022 N MAIN STREET EXT
Mailing Address - Street 2:
Mailing Address - City:BUTLER
Mailing Address - State:PA
Mailing Address - Zip Code:16001-1956
Mailing Address - Country:US
Mailing Address - Phone:724-282-8491
Mailing Address - Fax:724-282-8520
Practice Address - Street 1:1022 N MAIN STREET EXT
Practice Address - Street 2:
Practice Address - City:BUTLER
Practice Address - State:PA
Practice Address - Zip Code:16001-1956
Practice Address - Country:US
Practice Address - Phone:724-282-8491
Practice Address - Fax:724-282-8520
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-26
Last Update Date:2012-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAD0044600237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid FitterGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA587306OtherHIGHMARK BC BS
PA309202OtherUPMC HEALTH PLAN