Provider Demographics
NPI:1063885648
Name:KING AUDIOLOGY, LLC
Entity type:Organization
Organization Name:KING AUDIOLOGY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUDIOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:KING
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:423-244-5555
Mailing Address - Street 1:311 CONGRESS PKWY N
Mailing Address - Street 2:SUITE 200
Mailing Address - City:ATHENS
Mailing Address - State:TN
Mailing Address - Zip Code:37303-1699
Mailing Address - Country:US
Mailing Address - Phone:423-745-6222
Mailing Address - Fax:866-419-1447
Practice Address - Street 1:311 CONGRESS PKWY N
Practice Address - Street 2:SUITE 200
Practice Address - City:ATHENS
Practice Address - State:TN
Practice Address - Zip Code:37303-1699
Practice Address - Country:US
Practice Address - Phone:423-744-5944
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-04
Last Update Date:2019-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1202332S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332S00000XSuppliersHearing Aid Equipment