Organization
HEARING DIAGNOSTICS CENTER PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID C CRAIG AU.D. (OWNER/PRESIDENT)
(574) 534-4171
Entity
Organization
Contact information
Practice address
1206 COLLEGE AVE, SUITE 1, GOSHEN, IN 46526-4937
(574) 534-4171
(574) 533-3466
Mailing address
1206 COLLEGE AVE, SUITE 1, GOSHEN, IN 46526-4937
(574) 534-4171
(574) 533-3466
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
58000001A
IN
237600000X
Audiologist-Hearing Aid Fitter
Primary
58000001A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000087117
ANTHEM BCBS AUDIOLOGY
—
01
—
000000201762
HA SUPPLIER (DME)
IN
01
—
0303310002
ADMINISTAR
IN
05
—
100113470A
—
IN
Enumeration date
11/29/2005
Last updated
11/07/2013
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