Provider Demographics
NPI:1699935445
Name:DEARBORN HEARING CARE LLC
Entity type:Organization
Organization Name:DEARBORN HEARING CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JEFF
Authorized Official - Middle Name:
Authorized Official - Last Name:MESMER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:812-577-0322
Mailing Address - Street 1:432 WALNUT ST UNIT A
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEBURG
Mailing Address - State:IN
Mailing Address - Zip Code:47025-2035
Mailing Address - Country:US
Mailing Address - Phone:812-577-0322
Mailing Address - Fax:812-577-0323
Practice Address - Street 1:432 WALNUT ST UNIT A
Practice Address - Street 2:
Practice Address - City:LAWRENCEBURG
Practice Address - State:IN
Practice Address - Zip Code:47025-2035
Practice Address - Country:US
Practice Address - Phone:812-577-0322
Practice Address - Fax:812-577-0323
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-16
Last Update Date:2008-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN17001272A261QH0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech