Provider Demographics
NPI:1912042136
Name:SOUTHEASTERN HEARING INC.
Entity type:Organization
Organization Name:SOUTHEASTERN HEARING INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:TROY
Authorized Official - Middle Name:C
Authorized Official - Last Name:MAHAN
Authorized Official - Suffix:
Authorized Official - Credentials:HIS-BC
Authorized Official - Phone:904-247-4327
Mailing Address - Street 1:4006 3RD ST S
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32250
Mailing Address - Country:US
Mailing Address - Phone:904-247-4327
Mailing Address - Fax:904-247-4328
Practice Address - Street 1:12220 ATLANTIC BLVD
Practice Address - Street 2:UNIT 113
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32225-5822
Practice Address - Country:US
Practice Address - Phone:904-220-3277
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-21
Last Update Date:2025-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist