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Organization

EAR NOSE AND THROAT ASSOCIATES, P.C.

Active
Other names
Watauga Hearing Conservation
Organization subpart
No

Provider details

NPI number
Authorized official
MR. RUSSELL J FANKHOUSER CCCA (AUDIOLOGIST)
(423) 929-9101
Entity
Organization

Contact information

Practice address
215 E WATAUGA AVE, JOHNSON CITY, TN 37601-4671
(423) 929-9101
(423) 434-2032
Mailing address
215 E WATAUGA AVE, JOHNSON CITY, TN 37601-4671
(423) 929-9101
(423) 434-2032

Taxonomy

Speciality
Code
Description
License number
State
237600000X
Audiologist-Hearing Aid Fitter
Primary
A0000000247
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
3373581
CIGNA MEDICARE
TN
01
CA7519
RAILROAD MEDICARE
TN
Enumeration date
10/25/2006
Last updated
07/18/2008
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