Provider Demographics
NPI:1124149778
Name:R D OBERMEIER HEARING SERVICES L.L.C.
Entity type:Organization
Organization Name:R D OBERMEIER HEARING SERVICES L.L.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:LICENSED HEARING SPECIALIST
Authorized Official - Prefix:MR
Authorized Official - First Name:ROGER
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:OBERMEIER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:573-635-8226
Mailing Address - Street 1:724 W STADIUM BLVD
Mailing Address - Street 2:
Mailing Address - City:JEFFERSON CITY
Mailing Address - State:MO
Mailing Address - Zip Code:65109-4772
Mailing Address - Country:US
Mailing Address - Phone:573-635-8226
Mailing Address - Fax:573-636-3657
Practice Address - Street 1:724 W STADIUM BLVD
Practice Address - Street 2:
Practice Address - City:JEFFERSON CITY
Practice Address - State:MO
Practice Address - Zip Code:65109-4772
Practice Address - Country:US
Practice Address - Phone:573-635-8226
Practice Address - Fax:573-636-3657
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO001129237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument SpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
43166OtherMERCY HEALTH PROVIDER #
693841OtherHEALTHLINK PROVIDER #