Individual
DR. JOHN J HETHERINGTON
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
177 W COTTONWOOD LN, STE 7, CASA GRANDE, AZ 85222-2552
(520) 836-4618
(520) 836-2650
Mailing address
177 W COTTONWOOD LN, STE 7, CASA GRANDE, AZ 85222-2552
(520) 836-4618
(520) 836-2650
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
DA4090
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
133376
DEPT OF LABOR & INDUSTRIE
WA
01
—
1Z2179
HEALTHNET
AZ
05
—
802117
—
AZ
01
—
AZOO76260
BLUE CROSS/BLUE SHIELD
AZ
Enumeration date
05/24/2005
Last updated
07/08/2007
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