Provider Demographics
NPI:1316110240
Name:APPALACHIAN AUDIOLOGY, PLLC
Entity type:Organization
Organization Name:APPALACHIAN AUDIOLOGY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JANICE
Authorized Official - Middle Name:R
Authorized Official - Last Name:DUNGAN
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:865-357-2334
Mailing Address - Street 1:130 MABRY HOOD RD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37922-2221
Mailing Address - Country:US
Mailing Address - Phone:865-357-2334
Mailing Address - Fax:865-357-2416
Practice Address - Street 1:130 MABRY HOOD RD
Practice Address - Street 2:SUITE 103
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37922-2221
Practice Address - Country:US
Practice Address - Phone:865-357-2334
Practice Address - Fax:865-357-2416
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-11
Last Update Date:2011-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNA142231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4175747Medicare PIN